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Individual

CARRIE A LEISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4465 DARROW RD, STE 100, STOW, OH 44224
(330) 688-9918
(330) 688-6338
Mailing address
4465 DARROW RD, STOW, OH 44224-1884
(330) 688-9918
(330) 688-6338

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50000944
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0428273
OH
Enumeration date
09/22/2005
Last updated
04/24/2025
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