Individual
MRS. PATRICIA ROSE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8259 STATE ROUTE 88, RAVENNA, OH 44266-9158
(330) 296-0322
(330) 296-0322
Mailing address
8259 STATE ROUTE 88, RAVENNA, OH 44266-9158
(330) 296-0322
(330) 296-0322
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084355
—
OH
Enumeration date
11/04/2020
Last updated
11/04/2020
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