Individual
JILL K. PEYSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5105 SOM CENTER RD #107, WILLOUGHBY, OH 44094
(440) 953-5712
(440) 953-5713
Mailing address
1250 E. MARSHALL ST, BOX 980135, RICHMOND, VA 23298
(804) 828-7391
(804) 828-0191
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101269063
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35.146110
OHIO ELICENSE
OH
Enumeration date
04/23/2014
Last updated
10/13/2022
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