Individual
MR. DERRICK LAMAR HYCHE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1522 E 173RD ST, CLEVELAND, OH 44110-2933
(216) 531-9154
Mailing address
1522 E 173RD ST, CLEVELAND, OH 44110-2933
(216) 531-9154
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.122593
OH
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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