Individual
MISS DALLAS CHEYANNE BREEZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
817 SUCK RUN RD, MANCHESTER, OH 45144-8410
(937) 217-8583
Mailing address
817 SUCK RUN RD, MANCHESTER, OH 45144-8410
(937) 217-8583
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
515296
—
OH
Enumeration date
05/19/2020
Last updated
05/19/2020
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