Individual
DEWEY THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
60615 BOLAR RD, MC ARTHUR, OH 45651-8640
(740) 541-0912
Mailing address
60615 BOLAR RD, MC ARTHUR, OH 45651-8640
(740) 541-0912
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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