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Individual

GARY W HUMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
688 DICKERSON RD, WILLOWICK, OH 44095-4223
(440) 840-3978
Mailing address
688 DICKERSON RD, WILLOWICK, OH 44095-4223
(440) 840-3978

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
251X00000X
Supports Brokerage Agency
3747P1801X
Personal Care Attendant
376J00000X
Homemaker

Other

Enumeration date
11/20/2020
Last updated
11/20/2020
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