Individual
CINDY LOU ROACH II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31900 N MARGINAL DR, WILLOWICK, OH 44095-4427
(440) 347-0209
Mailing address
1550 GROVE AVE, MADISON, OH 44057-1016
(440) 645-7829
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105189477099
—
OH
Enumeration date
03/08/2007
Last updated
07/09/2007
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