Individual
STACIE MENCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5195 MAYFIELD RD, SUITE 10, LYNDHURST, OH 44124-2464
(440) 720-1810
(440) 720-1814
Mailing address
5195 MAYFIELD RD, SUITE 10, LYNDHURST, OH 44124-2464
(440) 720-1810
(440) 720-1814
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
33.015830
OH
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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