Individual
CHEVY NOVA CAVALEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
665 FLINT RIDGE RD, ZANESVILLE, OH 43701-8298
(740) 644-6249
Mailing address
665 FLINT RIDGE RD, ZANESVILLE, OH 43701-8298
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401909371116
OH
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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