Provider Demographics
NPI:1689276404
Name:CLINE, GREGORY CHARLES
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:CHARLES
Last Name:CLINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9012 W MORELAND RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2466
Mailing Address - Country:US
Mailing Address - Phone:440-537-2265
Mailing Address - Fax:
Practice Address - Street 1:9012 W MORELAND RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2466
Practice Address - Country:US
Practice Address - Phone:440-537-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant