Organization
SO ESTHEVA WELLNESS MEDSPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLIVIA NICOLE LUST PA (CO-OWNER/PROVIDER)
(330) 635-2782
Entity
Organization
Contact information
Practice address
5730 CLEVELAND RD, WOOSTER, OH 44691-1146
(330) 846-4100
Mailing address
1447 RUMBAUGH CIR, WOOSTER, OH 44691-3009
(306) 352-7823
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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