Individual
EBONY VASSAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11509 HANOVER RD, CINCINNATI, OH 45240-2434
(513) 648-0275
Mailing address
11509 HANOVER RD, CINCINNATI, OH 45240-2434
(513) 648-0275
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN126340
OH
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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