Individual
BRENT FRANK FUSSELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6643 FIRST AVE., ANDOVER, OH 44003
(440) 645-9543
Mailing address
6643 FIRST AVE., ANDOVER, OH 44003
(440) 645-9543
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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