Tierra Bacon's National Provider Identifier (NPI) Details
Tierra Bacon, SWT BA
NPI: 1629625710
Enumeration Date: 2019-08-22
Last updated: 2019-08-22
Sole Proprietor: YES
Status: active
Postal Address: 434 EASTLAND RD, BEREA, OH
Phone: 440-234-2006
Primary Practice Address: 3500 CARNEGIE AVE, CLEVELAND, OH
Practice's phone: 440-260-8300