Individual
JAMES LA RUE ISLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
628 W LIBERTY ST, SPRINGFIELD, OH 45506-2026
(567) 804-3293
Mailing address
628 W LIBERTY ST, SPRINGFIELD, OH 45506-2026
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
171M00000X
OH
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
05/30/2024
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