Healthcare Provider Details

I. General information

NPI: 1316623366
Provider Name (Legal Business Name): CHLOE FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 SYCHAR RD
MOUNT VERNON OH
43050-1837
US

IV. Provider business mailing address

800 MARTINSBURG RD
MOUNT VERNON OH
43050-9509
US

V. Phone/Fax

Practice location:
  • Phone: 330-472-4303
  • Fax:
Mailing address:
  • Phone: 330-472-4303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: