Individual
MRS. CYNTHIA ANN ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4529 BLUEBERRY AVE, DAYTON, OH 45406-3328
(937) 276-4412
Mailing address
4529 BLUEBERRY AVE, DAYTON, OH 45406-3328
(937) 276-4412
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
143507
OH
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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