Individual
DEANNA WILTROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2491 WILLOWBROOK PL, ROAMING SHORES, OH 44084-9611
(440) 563-9611
Mailing address
2491 WILLOWBROOK PL, ROAMING SHORES, OH 44084-9611
(440) 563-9611
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-111154
OH
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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