Individual
MRS. ALISA BLAIR-TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1428 ANSEL RD, CLEVELAND, OH 44106-4006
(216) 235-3613
Mailing address
1428 ANSEL RD, CLEVELAND, OH 44106-4006
(216) 235-3613
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
126602
OH
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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