Individual
ALVA PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPRS
Contact information
Practice address
551 E MAIN ST, LANCASTER, OH 43130-3809
(614) 404-6008
Mailing address
PO BOX 243, SUGAR GROVE, OH 43155-0243
(614) 779-5287
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005380
OH
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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