Organization
TIM DOUGLASS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM D DOUGLASS (DRIVER)
(740) 485-8529
Entity
Organization
Contact information
Practice address
14060 VINCENT RD, MOUNT VERNON, OH 43050-8283
(740) 485-8529
Mailing address
14060 VINCENT RD, MOUNT VERNON, OH 43050-8283
(740) 485-8529
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
RP410135
OH
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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