Individual
STEPHANIE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3742 W 139TH ST, CLEVELAND, OH 44111-4460
(216) 209-3742
Mailing address
3742 W 139TH ST, CLEVELAND, OH 44111-4460
(216) 209-3742
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
RL060485
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0390632
—
OH
05
—
0486892
—
OH
Enumeration date
08/09/2019
Last updated
07/14/2022
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