Individual
MICHELLE DIANE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1196 GINKO DR, WEST SALEM, OH 44287-9138
(216) 407-2132
Mailing address
1196 GINKO DR, WEST SALEM, OH 44287-9138
(216) 407-2132
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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