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General NPI Number Information
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NPI Number | 1407228851
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Entity Type | Organization
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Legal Business Name | RITAS ELECTROLYSIS CLINIC & PERSONAL CARE CENTER LLC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 27540 DETROIT RD STE 105
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City | WESTLAKE
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State | OH
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Zip | 44145-2299
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Country | US
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Telephone | 440-835-1047
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Fax |
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Provider Business Mailing Address
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Address Line | 27540 DETROIT RD STE 105
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City | WESTLAKE
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State | OH
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Zip | 44145-2299
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Country | US
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Telephone | 440-835-1047
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Fax |
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Authorized Official
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Title or Position | OWNER/ELECTROLOGIST
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Name | MS. RITA MARIE OLIMAN
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Credential | C.T.
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Telephone | 440-835-1047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 32.003835-N-R
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License Number State | OH
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