Individual
DUSTIN TG VACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 455-2101
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 453-8252
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1700221TRNE
OH
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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