Individual
CRAIG MASON STUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
16 MOHICAN DR, FREDERICKTOWN, OH 43019-8521
(740) 504-5626
Mailing address
16 MOHICAN DR, FREDERICKTOWN, OH 43019-8521
(740) 504-5626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN141893
OH
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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