Individual
ELIZABETH ANNE MIDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
272 N BURGESS AVE, COLUMBUS, OH 43204-3308
(614) 279-9229
Mailing address
272 N BURGESS AVE, COLUMBUS, OH 43204-3308
(614) 279-9229
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
2510492
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2510492
—
OH
01
—
2525315
ODMRDD CONTRACT NUMBER
OH
Enumeration date
04/19/2007
Last updated
07/09/2007
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