Individual
DISHANNA TOMEKA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1770 IDLEHURST DR, EUCLID, OH 44117-1848
(216) 554-2234
Mailing address
1770 IDLEHURST DR, EUCLID, OH 44117-1848
(216) 554-2234
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
117858
OH
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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