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General NPI Number Information
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NPI Number | 1659937977
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Entity Type | Organization
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Legal Business Name | EZHEALTHLIVE INC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 124 W MAIN ST STE 213B
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City | LANCASTER
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State | OH
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Zip | 43130-3763
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Country | US
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Telephone | 888-417-6543
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2389
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City | LANCASTER
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State | OH
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Zip | 43130-5389
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Country | US
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Telephone | 740-675-2186
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TIFFANY R CLAUSS
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Credential |
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Telephone | 888-417-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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