Individual
GARY TODD MCCOLLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 S STATE ROUTE 133, BLANCHESTER, OH 45107-8483
(513) 519-2449
Mailing address
1520 S STATE ROUTE 133, BLANCHESTER, OH 45107-8483
(513) 519-2449
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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