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Organization

INDIVIDUAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TAMMIE LYNN MAYLE (HOME HEALTH AID)
(330) 209-0732
Entity
Organization

Contact information

Practice address
1111 GONDER AVENUE SE, CANTON, OH 44707
(330) 209-0732
Mailing address
1111 GONDER AVE SE, CANTON, OH 44707-3321
(330) 209-0732

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
OH

Other

Enumeration date
09/30/2016
Last updated
09/30/2016
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