Individual
ALICE ACHA GWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1500 SHERWOOD DR APT 3F, FAIRFIELD, OH 45014-4165
(513) 410-9626
Mailing address
1500 SHERWOOD DR APT 3F, FAIRFIELD, OH 45014-4165
(513) 410-9626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 134891 IV
OH
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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