| Brye Roth Llc | |
|
15644 Madison Ave Ste 216 Lakewood OH 44107-5622 | |
| (440) 508-6765 | |
| Not Available |
| Full Name | Brye Roth Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 15644 Madison Ave Ste 216, Lakewood, Ohio |
| Authorized Official Name and Position | Brye Roth (OWNER) |
| Authorized Official Contact | 4404543243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brye Roth Llc 1527 Winton Ave Lakewood OH 44107-3613 Ph: () - | Brye Roth Llc 15644 Madison Ave Ste 216 Lakewood OH 44107-5622 Ph: (440) 508-6765 |
| NPI Number | 1144003807 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144003807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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