Individual
CARLENA KRISTINA TRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 W 101ST ST, CLEVELAND, OH 44102-3636
(216) 855-6559
Mailing address
2133 W 101ST ST, CLEVELAND, OH 44102-3636
(216) 855-6559
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103545850299
—
OH
Enumeration date
02/08/2021
Last updated
02/08/2021
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