Individual
CLARENCE L BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 S HIGH ST, COLUMBUS, OH 43207-1045
(614) 643-6822
Mailing address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
(614) 929-0662
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
174939
OH
Other
Enumeration date
04/15/2021
Last updated
04/19/2021
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