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Individual

LAVADA S KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
344 GRACE ST, MANSFIELD, OH 44902-1173
(419) 612-1581
Mailing address
344 GRACE STREET, MANSFIELD, OH 44902-1571
(419) 612-1581

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
376J00000X
Homemaker
Primary
376K00000X
Nurse's Aide
401680850814
OH

Other

Enumeration date
01/19/2022
Last updated
10/31/2024
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