| NPI | 1881000461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L TILLMAN Pn.M Iv 216-246-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.143666M-IV) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |