Individual
MRS. ANNIE C. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17930 PARKMOUNT AVE, CLEVELAND, OH 44135-4127
(216) 362-6074
Mailing address
17930 PARAMOUNT AVE., CLEVELAND, OH 44135-4127
(216) 804-7494
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
OH
376K00000X
Nurse's Aide
Primary
401025140110
OH
Other
Enumeration date
02/22/2011
Last updated
11/08/2016
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