Individual
COLLEEN MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4898 WALDAMERE AVE, WILLOUGHBY, OH 44094-5771
(440) 479-4846
Mailing address
4898 WALDAMERE AVE, WILLOUGHBY, OH 44094-5771
(440) 479-4846
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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