| Ellice Park Llc | |
|
4449 Easton Way Ste 200 Columbus OH 43219-7005 | |
| (614) 568-3233 | |
| Not Available |
| Full Name | Ellice Park Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4449 Easton Way Ste 200, Columbus, Ohio |
| Authorized Official Name and Position | Ellice Park (ADMINISTRATOR) |
| Authorized Official Contact | 6145683233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellice Park Llc Po Box 910 Lot 1210 Columbus OH 43216 Ph: (614) 568-3233 | Ellice Park Llc 4449 Easton Way Ste 200 Columbus OH 43219-7005 Ph: (614) 568-3233 |
| NPI Number | 1457029373 |
|---|---|
| Provider Enumeration Date | 09/03/2021 |
| Last Update Date | 09/03/2021 |
| Certification Date | 09/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457029373 | NPI | - | NPPES |
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