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1629115779
CHARLES MACK LEE
CLEVELAND, OH
NPI
1629115779
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
374U00000X Home Health Aide
(Licence: OH 400327400204)
Enumeration Date
2007-01-30
Last Update Date
2007-07-08
Business Address
-- CHARLES MACK LEE STNA
3919 E 147TH ST
CLEVELAND, OH 44128-1082
Phone number: 216-832-7732
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Mailing Address
-- CHARLES MACK LEE STNA
PO BOX 19483
CLEVELAND, OH 44119-0483
Phone number: 216-832-7732
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