Individual
AHMAD S JALLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5651 ELLIOTT DR., SYLVANIA, OH 43560-4356
(718) 300-0318
Mailing address
5651 ELLIOTT DR, SYLVANIA, OH 43560-2064
(718) 300-0318
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
023083
OH
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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