Individual
TARA WYSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24124 STATE ROUTE 2, ARCHBOLD, OH 43502-9453
(419) 572-1944
Mailing address
24124 STATE ROUTE 2, ARCHBOLD, OH 43502-9453
(419) 572-1944
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/15/2020
Last updated
11/15/2020
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