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Individual

MR. NATHAN R HEATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
769 SUNSET BLVD APT 8, MANSFIELD, OH 44907-2660
(419) 631-3687
Mailing address
769 SUNSET BLVD APT 8, MANSFIELD, OH 44907-2660
(419) 631-3687

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
174200000X
Meals Provider
347C00000X
Private Vehicle

Other

Enumeration date
05/20/2021
Last updated
05/20/2021
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