Individual
MRS. KAREN SUE CANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10270 BRADFORD BLOOMER RD, COVINGTON, OH 45318-8809
(937) 526-3038
Mailing address
10270 BRADFORD BLOOMER RD, COVINGTON, OH 45318-8809
(937) 526-3038
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101245
MEDICAID PROVIDER
OH
Enumeration date
03/31/2015
Last updated
03/31/2015
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