Individual
CAROL REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 EAST 141, ST., CLEVELAND, OH 44110-3685
(216) 301-5387
Mailing address
1113 EAST 141ST, CLEVELAND, OH 44110-3685
(216) 301-5387
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7566
OH
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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