Organization
WESTSIDE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON DICECCO (BILLING ADMIN.)
(513) 898-9111
Entity
Organization
Contact information
Practice address
4342 HARRISON AVE, CINCINNATI, OH 45211-3322
(513) 898-9111
(844) 519-2824
Mailing address
4342 HARRISON AVE, CINCINNATI, OH 45211-3322
(513) 898-9111
(844) 519-2824
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3504319
OH
Other
Enumeration date
11/09/2016
Last updated
12/14/2016
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