Individual
LADONNA DICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4452 E 156TH ST, CLEVELAND, OH 44128-2913
(216) 970-3713
Mailing address
4452 E 156TH ST, CLEVELAND, OH 44128-2913
(216) 970-3713
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RP927953
OH
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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