Individual
ILKHOM DURSUNOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9331 LAKESIDE ST, TIPP CITY, OH 45371-2590
(215) 939-6785
Mailing address
9331 LAKESIDE ST, TIPP CITY, OH 45371-2590
(215) 939-6785
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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