Individual
KALIEB BENJAMIN HANICQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
534 DEGLER ST APT 32, DEFIANCE, OH 43512-2552
(419) 771-7175
Mailing address
534 DEGLER ST APT 32, DEFIANCE, OH 43512-2552
(419) 771-7175
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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