Individual
MS. JANICE LEE FETHEROLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AID
Contact information
Practice address
12209 LECORNE ST, MILLERSPORT, OH 43046
(740) 507-8544
Mailing address
15231 ST RT #93 SOUTH, LOGAN, OH 43138
(740) 380-6210
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
253359
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105552217999
—
OH
Enumeration date
04/04/2007
Last updated
07/08/2007
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