Individual
AMY JO MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
410 KINZER RD, BAINBRIDGE, OH 45612-8800
(740) 634-3252
Mailing address
410 KINZER RD, BAINBRIDGE, OH 45612-8800
(740) 634-3252
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN117637
OH
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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