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General NPI Number Information
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NPI Number | 1649728619
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Entity Type | Organization
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Legal Business Name | EXPRESSIVE HEALTHCARE ACADEMY LLC
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 4479 BROADVIEW RD
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City | CLEVELAND
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State | OH
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Zip | 44109-4302
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Country | US
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Telephone | 216-916-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 4479 BROADVIEW RD
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City | CLEVELAND
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State | OH
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Zip | 44109-4302
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Country | US
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Telephone | 216-916-9282
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHLEEN DAWELLA MOSLEY
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Credential |
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Telephone | 216-916-9282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State | OH
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