KELLY SAMPLE

CHARDON, OH
NPI1427646025
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy376J00000X Homemaker
Enumeration Date2021-01-08
Last Update Date2021-01-08
Business Address
KELLY SAMPLE
12065 NICKI LN
CHARDON, OH 44024-8941
Phone number: 440-226-0867
Mailing Address
KELLY SAMPLE
12065 NICKI LN
CHARDON, OH 44024-8941
Phone number: 440-226-0867
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