Individual
BRADLEY FERNANDO WILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 E 215TH ST, EUCLID, OH 44123-1944
(216) 213-8926
Mailing address
312 E 215TH ST, EUCLID, OH 44123-1944
(216) 213-8926
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-086367
OH
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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