Individual
JACQUELINE REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
453 GREENVALE RD, SOUTH EUCLID, OH 44121-2310
(216) 534-8276
Mailing address
453 GREENVALE RD, SOUTH EUCLID, OH 44121-2310
(216) 534-8276
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
1816020
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189779802901
—
OH
Enumeration date
09/16/2020
Last updated
09/16/2020
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