Provider Demographics
NPI:1861250912
Name:MEDLEY, ESCHERICA (CPS)
Entity type:Individual
Prefix:
First Name:ESCHERICA
Middle Name:
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 EUCLID AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4003
Mailing Address - Country:US
Mailing Address - Phone:216-622-5610
Mailing Address - Fax:
Practice Address - Street 1:7000 EUCLID AVE STE 203
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4003
Practice Address - Country:US
Practice Address - Phone:216-622-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHJOWIIDTYAL225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter