Organization
TANA M POWELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANA MARIE POWELL LPN (NURSE)
(419) 290-4741
Entity
Organization
Contact information
Practice address
4741 WICKFORD DR W, SYLVANIA, OH 43560-3357
(419) 290-4741
Mailing address
4741 WICKFORD DR W, SYLVANIA, OH 43560-3357
(419) 290-4741
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
PN.134008-IV
OH
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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