Individual
CHARLES EVAN TRAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2211 LAKE CLUB DR, COLUMBUS, OH 43232-3204
(614) 704-5224
Mailing address
2344 MINERVA PARK PL, COLUMBUS, OH 43229-4770
(614) 286-3863
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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