Individual
KATHERINE ANN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1063 CHURCH ST, LOGAN, OH 43138-1024
(740) 385-5187
Mailing address
1063 CHURCH ST, LOGAN, OH 43138-1024
(740) 385-5187
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099910
—
OH
Enumeration date
10/02/2020
Last updated
10/02/2020
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