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Individual

MICHAEL LEO JESSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7856 BROOKSIDE DR, OLMSTED FALLS, OH 44138-1653
(440) 235-3711
(440) 235-3786
Mailing address
32800 LORAIN RD STE 2100, NORTH RIDGEVILLE, OH 44039-3430
(440) 235-3711

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34003567
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341842373008
BWC
OH
05
711484
OH
Enumeration date
04/25/2006
Last updated
11/06/2020
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