Individual
MS. CAROL AMANDA VANTILBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
835 PEACEFUL PATH, MANSFIELD, OH 44907-2021
(419) 756-7472
Mailing address
835 PEACEFUL PATH, MANSFIELD, OH 44907-2021
(419) 756-7472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.068367
OH
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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