Individual
LIDEJA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12507 MARSTON AVE, CLEVELAND, OH 44105-5452
(216) 414-2445
Mailing address
12507 MARSTON AVE, CLEVELAND, OH 44105-5452
(216) 414-2445
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
TR162530
OH
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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