Individual
DESTINEE M CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 WAYNE ST, COLUMBUS GROVE, OH 45830-1030
(419) 388-6145
Mailing address
510 WAYNE ST, COLUMBUS GROVE, OH 45830-1030
(419) 388-6145
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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