Individual
IVORY HOLLAMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 LIPPERT RD NE, CANTON, OH 44705-1019
(937) 889-8000
Mailing address
318 CHICAGO PL NW, CANTON, OH 44703-1726
(614) 815-8914
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/20/2015
Last updated
03/14/2018
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