Individual
PAMELA M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LME
Contact information
Practice address
458 BERWICK CIR, AURORA, OH 44202-8560
(216) 440-8905
Mailing address
458 BERWICK CIR, AURORA, OH 44202-8560
(216) 440-8905
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ESTM.071064
OH
Other
Enumeration date
08/23/2011
Last updated
08/28/2011
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