Individual
CHARLES CLARK HALL I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8210 BELLE VERNON DR, NOVELTY, OH 44072-9700
(440) 781-9448
Mailing address
PO BOX 103, CHESTERLAND, OH 44026-0103
(440) 781-9448
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
2801936
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2801936
—
OH
Enumeration date
10/29/2020
Last updated
10/29/2020
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