Individual
KIM CHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68 BUHL BLVD, SHARON, PA 16146-3706
(888) 424-0094
Mailing address
418 PARKVIEW DR, HUBBARD, OH 44425-2277
(888) 424-0094
(888) 424-0094
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
1924515
OH
171W00000X
Contractor
Primary
PA016151
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0357697
—
OH
Enumeration date
02/05/2020
Last updated
02/05/2020
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