Individual
KRIS B INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 S BEAVER ST, CARROLL, OH 43112-9002
(740) 756-4058
Mailing address
PO BOX 116, CARROLL, OH 43112-0116
(740) 215-7093
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084066
—
OH
Enumeration date
09/12/2020
Last updated
09/12/2020
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