Individual
BOPHA BAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6390 FIRETHORN AVE, REYNOLDSBURG, OH 43068-1073
(740) 870-6684
Mailing address
6390 FIRETHORN AVE, REYNOLDSBURG, OH 43068-1073
(740) 870-6684
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
OH
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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