Individual
ICESIS LOVE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
446 S BROADWAY ST, DAYTON, OH 45402-8130
(937) 349-6721
Mailing address
446 S BROADWAY ST, DAYTON, OH 45402-8130
(937) 349-6721
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
TP784034
OH
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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