Individual
HACKER COMBS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13756 ROAD 154, PAULDING, OH 45879-8912
(419) 769-2339
Mailing address
13756 ROAD 154, PAULDING, OH 45879-8912
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115889
—
OH
Enumeration date
10/09/2020
Last updated
10/09/2020
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