Idrissa Derra
Idrissa Derra is a Contractor in Brunswick, Ohio. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
3906 Turnbridge Ct Unit 311Brunswick, OH 44212-3093
Phone: (216) 801-5639
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Specialties & licences
| Contractor (primary) | Taxonomy 171W00000X |
|---|
Record details
| NPI number | 1194309989 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 8, 2021 |
| Last updated in NPPES | November 28, 2022 |
| Certification date | November 27, 2022 |
| Mailing address | 3906 Turnbridge Ct Unit 311, Brunswick, OH 44212-3093 |
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