Individual
MR. KEITH ROBERT DEMETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5354 NEW CASTLE RD, LOWELLVILLE, OH 44436
(330) 755-7090
Mailing address
5354 NEW CASTLE RD, LOWELLVILLE, OH 44436-9532
(330) 755-7090
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0842888
—
OH
05
—
2059721
—
OH
Enumeration date
07/19/2006
Last updated
08/01/2018
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