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Individual

SUSAN OBHOF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1600 LENOX NEW LYME RD TRLR 49, JEFFERSON, OH 44047-9562
(440) 645-0339
Mailing address
1600 LENOX NEW LYME RD TRLR 49, JEFFERSON, OH 44047-9562
(440) 645-0339

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401982800717
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0348586
OH
Enumeration date
11/30/2019
Last updated
11/30/2019
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