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1932583127
BRUCE SHAGOVAC
PARMA, OH
NPI
1932583127
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 051027)
Enumeration Date
2015-07-17
Last Update Date
2015-07-17
Business Address
-- BRUCE SHAGOVAC LCDC III # 051027
6753 STATE RD
PARMA, OH 44134-4517
Phone number: 440-843-5617
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Mailing Address
-- BRUCE SHAGOVAC LCDC III # 051027
6753 STATE RD
PARMA, OH 44134-4517
Phone number: 440-843-5617
Copy
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