Individual
CHARLES JACOB MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 BLOSSOM LN, SALEM, OH 44460-4284
(330) 337-3033
Mailing address
190 OVERLOOK BLVD, STRUTHERS, OH 44471-1615
(330) 272-2759
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007496
OH
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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