Individual
MR. IVAN D MCFANN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
10778 ROLLING ACRES DRIVE, GEORGETOWN, OH 45121
(513) 673-3186
Mailing address
10778 ROLLING ACRES DRIVE, GEORGETOWN, OH 45121
(513) 673-3186
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN111413
OH
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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