Individual
KEVIN FIDEL VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3877 W 34TH ST UNIT D, CLEVELAND, OH 44109-2711
(216) 538-3126
Mailing address
3877 W 34TH ST UNIT D, CLEVELAND, OH 44109-2711
(216) 538-3126
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
TY113643
OH
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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