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Individual

MR. JOHN MICHAEL CHANCEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1318 BRISTOL CT, CIRCLEVILLE, OH 43113-9231
(740) 412-8248
Mailing address
1318 BRISTOL CT, CIRCLEVILLE, OH 43113-9231
(740) 412-8248

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6502795
OH
Enumeration date
09/16/2020
Last updated
09/16/2020
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