Individual
EASTON ALAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 868-8776
Mailing address
58328 RICHPORT DR, SENECAVILLE, OH 43780-9456
(740) 586-1115
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
OH
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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