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Individual

MR. GREGORY DEAN FIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1643 BARDWELL WEST RD, WILLIAMSBURG, OH 45176-9648
(513) 967-3694
Mailing address
1643 BARDWELL WEST RD, WILLIAMSBURG, OH 45176-9648
(513) 724-2251

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
0362562
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0362562
OH
01
1305185
DSP
OH
Enumeration date
11/30/2020
Last updated
11/30/2020
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