Individual
ALVIN DERRELL WANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12311 THRAVES AVE, GARFIELD HTS, OH 44125-4307
(440) 506-1253
Mailing address
12311 THRAVES AVE, GARFIELD HTS, OH 44125-4307
(440) 506-1253
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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