Provider Information for 1669771747
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J. CHRISTOPHER CUDA LISW
Other Names:Professional Name:CHRIS J CUDA LISWSex: Male
NPI: 1669771747
Last Updated: 2018-08-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669771747 | ||||||||
| Enumeration Date | 2011-03-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1865 N RIDGE RD E STE D LORAIN, OH 44055-3359 United States Phone: 440-341-0270 | Fax:440-277-0459 | ||||||||
| Primary Practice Address | 1865 N RIDGE RD E STE D LORAIN, OH 44055 United States Phone: 440-341-0270 | Fax:440-277-0459 | ||||||||
| Secondary Practice Address(es) | 1865 N RIDGE RD E STE D | ||||||||
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