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Individual

ADJOWA OFFEI KORANTENG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
620 ALTONA DR, BLACKLICK, OH 43004-7102
(614) 397-3013
Mailing address
620 ALTONA DR, BLACKLICK, OH 43004-7102
(614) 397-3013

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
154177
OH

Other

Enumeration date
11/07/2022
Last updated
11/07/2022
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