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Individual

ROBERT R DURHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4566H TEALTOWN RD, BATAVIA, OH 45103-1025
(513) 943-7496
(513) 943-7480
Mailing address
PO BOX 416, BATAVIA, OH 45103-0416

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
3747P1801X
Personal Care Attendant
Primary
OH
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2175677
OH
Enumeration date
11/23/2020
Last updated
11/23/2020
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