DAVID BLAINE

LORAIN, OH
NPI1942017017
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
(Licence: OH  APS.000193)
Enumeration Date2024-12-12
Last Update Date2024-12-12
Business Address
DAVID BLAINE
6140 S BROADWAY
LORAIN, OH 44053-3821
Phone number: 440-233-7232
Mailing Address
DAVID BLAINE
6140 SOUTH BROADWAY
LORAIN, OH 44053-3821
Phone number:
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