Individual
MR. COLBY DALE DECAPUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-3743
(216) 445-6255
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003292
OH
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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