Individual
MICHELLE MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 NEWLAND RIDGE RD, WAVERLY, OH 45690-9279
(740) 970-8920
Mailing address
1408 NEWLAND RIDGE RD, WAVERLY, OH 45690-9279
(740) 970-8920
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601047
—
OH
Enumeration date
11/16/2020
Last updated
11/16/2020
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