Individual
ADA LYNN MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
224 PARK RD, CRESTLINE, OH 44827-1661
(419) 566-4201
Mailing address
224 PARK RD., CRESTLINE, OH 44827
(419) 566-4201
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
126727
OH
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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