Individual
MRS. CANDACE CLEO TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
22 ORCHARD ST, GREENWICH, OH 44837-1109
(419) 951-4838
Mailing address
22 ORCHARD ST, GREENWICH, OH 44837-1109
(419) 951-4838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
267166
OH
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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