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Organization

KENNETHIA BANNER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KENNETHIA LASHAY BANNER (LPN)
(567) 249-7660
Entity
Organization

Contact information

Practice address
6011 WILLOWVALE DR, TOLEDO, OH 43615-5734
(567) 249-7660
Mailing address
6011 WILLOWVALE DR, TOLEDO, OH 43615-5734
(567) 249-7660

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
138871
OH

Other

Enumeration date
04/05/2016
Last updated
04/05/2016
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