Individual
BETH ANN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4406 BROADHURST DR, WHITEHALL, OH 43213-1833
(614) 332-1373
Mailing address
PO BOX 132501, COLUMBUS, OH 43213-9501
(614) 332-1373
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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