Provider Demographics
NPI:1932779287
Name:FURR, RAVEN SYMONE
Entity Type:Individual
Prefix:
First Name:RAVEN
Middle Name:SYMONE
Last Name:FURR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33001 SOLON RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2864
Mailing Address - Country:US
Mailing Address - Phone:440-248-2866
Mailing Address - Fax:440-248-0242
Practice Address - Street 1:33001 SOLON RD STE 115
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2864
Practice Address - Country:US
Practice Address - Phone:440-248-2866
Practice Address - Fax:440-248-0242
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist