Most Relevant Information
Provider Data
| NPI Number: | 1003226978 |
| Provider Name: | MARY REVILLE |
| Entity Type: | Individual |
| Taxonomy Code: | 163WS0200X |
| Specialty: | Registered Nurse |
| License Number: | 166851 |
Most Important Dates
| Enumeration Date: | 05/01/2014 |
| Last Updated: | 05/01/2014 |
Provider Practice Location
10700 CHURCHILL AVE
CLEVELAND
OH
441061209
Practice Location Phone/Fax
| Phone: | 2167912496 |
| Fax: |
Provider Mailing Location
10700 CHURCHILL AVE
CLEVELAND
OH
441061209
Provider Mailing Phone/Fax
| Phone: | 2167912496 |
| Fax: |