Individual
ANGELA NICOLE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 KENWOOD DR APT J, EUCLID, OH 44123-2053
(216) 450-0629
Mailing address
421 KENWOOD DR APT J, EUCLID, OH 44123-2053
(216) 450-0629
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
SZ831260
OH
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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