Individual
CHARLES FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
748 ADMORE DR, KENT, OH 44240-1617
(330) 801-4784
Mailing address
748 ADMORE DR, KENT, OH 44240-1617
(330) 801-4784
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105773575399
—
OH
Enumeration date
10/08/2021
Last updated
10/20/2021
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