Individual
LUVENIA E. TANTOCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Mailing address
442 W HIGH ST, BRYAN, OH 43506-1681
(419) 636-4517
(419) 636-6438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35044848
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432973
—
OH
01
—
370002410
RAILROAD
OH
Enumeration date
03/22/2007
Last updated
05/20/2008
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