Individual
IBRAHIM ASSAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6779 BLUEBIRD PL, HILLIARD, OH 43026-2263
(614) 318-3139
Mailing address
6779 BLUEBIRD PL, HILLIARD, OH 43026-2263
(614) 318-3139
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
UA222622
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UA222622
—
OH
Enumeration date
03/30/2022
Last updated
03/30/2022
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