Organization
SANDY VALLEY PROF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCESCA P NICOLETTI (OFFICE MANAGER)
(330) 866-3309
Entity
Organization
Contact information
Practice address
10025 CLEVELAND AVE SE, MAGNOLIA, OH 44643-9781
(330) 866-3309
(330) 866-3077
Mailing address
PO BOX 419, EAST SPARTA, OH 44626-0419
(330) 866-3309
(330) 866-3077
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
75313
OH
Other
Enumeration date
12/18/2007
Last updated
01/03/2008
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