Organization
KO NURSE PRACTITIONER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KHURI MD (OWNER)
(216) 521-2255
Entity
Organization
Contact information
Practice address
15800 DETROIT AVE, LAKEWOOD, OH 44107-3748
(216) 226-8700
Mailing address
PO BOX 74692, CLEVELAND, OH 44194-0775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/25/2011
Last updated
09/20/2016
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