Individual
JUSTIN EDWARD BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
42331 GRISWOLD RD, ELYRIA, OH 44035-2121
(440) 284-8250
Mailing address
3776 W 137TH ST, CLEVELAND, OH 44111-4441
(440) 665-5390
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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