Individual
KINGSLEY ANDRIS ETUKUMOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2260 PAR LN APT 812, WILLOUGHBY HILLS, OH 44094-2949
(216) 357-1578
Mailing address
1400 LLOYD RD UNIT 164, WICKLIFFE, OH 44092-8605
(216) 357-1578
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/13/2019
Last updated
05/13/2019
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