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NPI 1861848277

NPI 1861848277 : LOLITA RICHMOND : WILLOUGHBY, OH

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General NPI Number Information
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    NPI Number           |    1861848277
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    Entity Type          |    Individual 
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    Provider Name        |    LOLITA RICHMOND
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/05/2016
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    Last Update Date     |    06/23/2022
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Provider Practice Location Address
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    Address Line         |    37903 EUCLID AVE 
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    City                 |    WILLOUGHBY
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    State                |    OH
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    Zip                  |    44094-5978
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    Country              |    US
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    Telephone            |    216-406-1195
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1502 
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    City                 |    WILLOUGHBY
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    State                |    OH
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    Zip                  |    44096-1502
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    Country              |    US
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    Telephone            |    216-406-1195
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171W00000X
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    Taxonomy Name        |    Contractor
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    License Number       |    
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    License Number State |    
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