Individual
JUSTIN VANCOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 2ND AVE, CHESAPEAKE, OH 45619-1134
(740) 451-0342
Mailing address
103 2ND AVE, CHESAPEAKE, OH 45619-1134
(740) 451-0342
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.179669
OH
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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