Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | PT016689 | OH |
Y | 213ES0000X | Sports Medicine | PT016689 | OH |
NPI | 1538676465 |
---|---|
Provider Name | Victoria Cichocki |
First Address | Rocky River, OH 44116-4144 |
Second Address | Rocky River, OH 44116-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2017 |
Last Update Date | 31/12/2017 |