Individual
REGINA BELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 PERRY ST, LOT 16, HICKSVILLE, OH 43526-1463
(419) 542-9717
Mailing address
400 PERRY ST, LOT 16, HICKSVILLE, OH 43526-1463
(419) 542-9717
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104657615199
—
OH
Enumeration date
04/05/2012
Last updated
04/05/2012
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