Individual
TAMIE DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
602 KNIGHTS AVE, GAHANNA, OH 43230-2355
(330) 204-5587
Mailing address
602 KNIGHTS AVE, GAHANNA, OH 43230-2355
(330) 204-5587
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN134334
OH
Other
Enumeration date
04/30/2011
Last updated
04/30/2011
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