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Individual

MARK NELLENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-4951
Mailing address
2175 KERWIN RD APT 503, UNIVERSITY HEIGHTS, OH 44118-3979
(315) 404-3055

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OH

Other

Enumeration date
09/10/2018
Last updated
09/10/2018
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