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Individual

CARLA WIDENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
612 E 222ND ST, EUCLID, OH 44123-2024
(216) 780-0686
Mailing address
612 E 222ND ST, EUCLID, OH 44123-2024
(216) 780-0686

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN:103552
OH

Other

Enumeration date
01/08/2015
Last updated
01/08/2015
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