Organization
PROFESSIONAL PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID O'NEILL (MANAGING MEMBER)
(440) 387-5500
Entity
Organization
Contact information
Practice address
38642 CENTER RIDGE RD, NORTH RIDGEVILLE, OH 44039-5812
(440) 387-5500
Mailing address
38642 CENTER RIDGE RD, NORTH RIDGEVILLE, OH 44039-5812
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/06/2024
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