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Individual

MICHELLE R HIESTAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1092 DONALD DR, GREENVILLE, OH 45331-2545
(937) 569-1578
Mailing address
1092 DONALD DR, GREENVILLE, OH 45331-2545
(937) 569-1578

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
OH
347C00000X
Private Vehicle
Primary

Other

Enumeration date
11/20/2020
Last updated
02/02/2021
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