MEDICARE: KEVIN P PIERCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1235701491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN P PIERCE

Provider Business Mailing Address
First Line	:	1102 FRESNO DR
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2730
Country	:	US
Telephone Number	:	440-506-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 FRESNO DR
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2730
Country	:	US
Telephone Number	:	440-506-2002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	07/15/2021

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Directions to “ KEVIN P PIERCE ” Practice Location

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