Individual
CHARLOTTE LYNN HACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12236 MARKET ST, NORTH LIMA, OH 44452-9770
(330) 718-6698
(330) 549-0383
Mailing address
6538 MARKET ST., BOARDMAN, OH 44512
(330) 549-9699
(330) 549-0383
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401815311215
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203879
—
OH
Enumeration date
02/13/2017
Last updated
04/25/2017
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