Individual
MR. KEVIN MARK SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4143 KARL RD APT 313, COLUMBUS, OH 43224-2090
(614) 749-9981
Mailing address
4143 KARL RD APT 313, COLUMBUS, OH 43224-2090
(614) 749-9981
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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