Individual
MR. ABSALOM CORY ALICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 889-6402
Mailing address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 476-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0030978
OH
Other
Enumeration date
03/14/2022
Last updated
06/29/2022
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