Individual
VIVIAN A CONDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR L CST
Contact information
Practice address
41640 PARSONS RD, LAGRANGE, OH 44050-9513
(440) 355-8032
(440) 355-4230
Mailing address
PO BOX 228, GRAFTON, OH 44044-0228
(440) 355-8032
(440) 355-4230
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
1133
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341605134
COMMERCIAL INSURANCE
OH
01
—
341605134-01
BWC
OH
01
—
341605134005
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
05/11/2007
Last updated
07/08/2007
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