Individual
EMILY KLUCAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1389 OHIO AVE LOT 40, LOGAN, OH 43138-9612
(740) 279-9013
Mailing address
21970 SR 664, SOUTH BLOOMINGVILLE, OH 43152
(740) 279-9013
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0337369
—
OH
Enumeration date
10/19/2020
Last updated
10/19/2020
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