Most Relevant Information
Provider Data
| NPI Number: | 1003543612 |
| Provider Name: | REECAUSETTER PERNELL |
| Entity Type: | Individual |
| Taxonomy Code: | 374700000X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/03/2022 |
| Last Updated: | 08/03/2022 |
Provider Practice Location
863 PROUTY AVE
TOLEDO
OH
436093262
Practice Location Phone/Fax
| Phone: | 4047590552 |
| Fax: |
Provider Mailing Location
863 PROUTY AVE
TOLEDO
OH
436093262
Provider Mailing Phone/Fax
| Phone: | 4047590552 |
| Fax: |