Doctor Name: | ELISEE NDENGA |
NPI Number: | 1295134666 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 442 Stone Shadow Dr Blacklick, OH - 43004 |
Business Phone Number: | 6142185743 |
Business Fax Number: | |
Mailing Address: | 442 Stone Shadow Dr, BLACKLICK |
State: | OH |
Postal Code: | 430048097 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/21/2014 |
NPI Last Update Date: | 08/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WV0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Vehicle Modifications |
Taxonomy Definition: | A contractor who makes modifications to private vehicles to accommodate a health condition. |