Organization
DUECE WAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. QUANTRAY DU'MONT ELLIS SR. (CEO)
(334) 473-0947
Entity
Organization
Contact information
Practice address
114 NORAN CIR, BEDFORD, OH 44146-2619
(334) 473-0947
Mailing address
114 NORAN CIR, BEDFORD, OH 44146-2619
(334) 473-0947
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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