Individual
JAKE RACICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16111 LARCHWOOD AVE, CLEVELAND, OH 44135-1205
(440) 578-8200
Mailing address
16111 LARCHWOOD AVE, CLEVELAND, OH 44135-1205
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
341498
OH
Other
Enumeration date
10/30/2019
Last updated
11/04/2019
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