Individual
A'NIS EZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 E 119TH ST, CLEVELAND, OH 44120-2117
(440) 283-8652
Mailing address
2811 E 119TH ST, CLEVELAND, OH 44120-2117
(440) 283-8652
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OH
Other
Enumeration date
10/29/2024
Last updated
11/04/2024
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