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Individual

TERRY LEE MORTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3485 W 129TH ST, CLEVELAND, OH 44111-3411
(440) 666-2336
Mailing address
3485 W 129TH ST, CLEVELAND, OH 44111-3411
(440) 666-2336

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
0083577
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0083577
OH
Enumeration date
06/12/2014
Last updated
06/12/2014
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