Individual
LEROY CALVIN KING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 WESTERN AVE, TOLEDO, OH 43609-2701
(419) 671-5550
Mailing address
617 WESTERN AVE, TOLEDO, OH 43609-2701
(419) 671-5550
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261QM0801X
—
OH
Enumeration date
07/17/2018
Last updated
07/17/2018
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