Individual
MRS. TISA E EWING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 YELLOW CREEK CIR, STRUTHERS, OH 44471-3114
(330) 506-1771
Mailing address
22 YELLOW CREEK CIR, STRUTHERS, OH 44471-3114
(330) 506-1771
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
4935123
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4935123
STATE OF OHIO
OH
Enumeration date
10/04/2022
Last updated
10/04/2022
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