Individual
RAVEN PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 W HIGH ST, MOUNT GILEAD, OH 43338-1215
(419) 947-7500
Mailing address
304 W MAIN ST, CARDINGTON, OH 43315-1049
(740) 262-5984
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/06/2016
Last updated
07/14/2021
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