Individual
ELIZABETH BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20611 EUCLID AVE, EUCLID, OH 44117-1521
(216) 859-2727
Mailing address
15402 GLENCOE AVE, CLEVELAND, OH 44110-1330
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.187118
OH
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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