Individual
DIMETA JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26241 LAKE SHORE BLVD, APT. 155, EUCLID, OH 44132-1140
(216) 835-1694
Mailing address
26241 LAKE SHORE BLVD, APT. 155, EUCLID, OH 44132-1140
(216) 835-1694
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN130214
OH
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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