NI KETUT KUMALA DEWI HARIADI

INDEPENDENCE, OH
NPI1114404159
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: OH  AG07180050)
Enumeration Date2018-07-23
Last Update Date2018-07-23
Business Address
NI KETUT KUMALA DEWI HARIADI
5001 ROCKSIDE RD
INDEPENDENCE, OH 44131-2172
Phone number: 216-986-4000
Mailing Address
NI KETUT KUMALA DEWI HARIADI
9000 MOSS POINTE CIR
OLMSTED TWP, OH 44138-8168
Phone number: 216-258-3660