Individual
SUE WYSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 MCVEY PL, SPRINGBORO, OH 45066-1125
(937) 748-1271
Mailing address
105 MCVEY PL, SPRINGBORO, OH 45066-1125
(937) 748-1271
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8305137
—
OH
Enumeration date
09/27/2020
Last updated
09/27/2020
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