Doctor Name: | RISTENKA PRNAROVA |
NPI Number: | 1922236447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 5101018279 |
Business Practice Address: | 29000 Center Ridge Rd Westlake, OH - 441455293 |
Business Phone Number: | 4408275566 |
Business Fax Number: | 4408275573 |
Mailing Address: | 29000 Center Ridge Rd, WESTLAKE |
State: | OH |
Postal Code: | 441455293 |
Phone Number: | 4408275566 |
Fax Number: | 4408275573 |
NPI Enumeration Date: | 06/23/2009 |
NPI Last Update Date: | 01/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5101018279 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |