Individual
DANIEL JOSEPH THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, HS
Contact information
Practice address
1240 E 9TH ST STE 2693, CLEVELAND, OH 44199-2061
(216) 902-6260
(216) 902-6197
Mailing address
1240 E 9TH ST STE 2693, CLEVELAND, OH 44199-2061
(216) 902-6260
(216) 902-6197
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
A001682
—
163WC0200X
Critical Care Medicine Registered Nurse
486357
OH
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
07/09/2024
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