Individual
KIMBERLY KAY HARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16986 BURRIS RD, OHIO CITY, OH 45874-9734
(419) 203-7712
Mailing address
16986 BURRIS RD, OHIO CITY, OH 45874-9734
(419) 203-7712
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245386
—
OH
01
—
8100763
DODD
OH
Enumeration date
10/06/2020
Last updated
10/06/2020
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