Individual
MR. MARTIN PHILLIP MIRISE
Active
Individual
MR. MARTIN PHILLIP MIRISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE AIDE
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
ODAPROV539434899
OH
376K00000X
Nurse's Aide
Primary
400765940608
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PROV539434899
OHIO DEPT. OF AGING
OH
Enumeration date
08/01/2018
Last updated
08/01/2018
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