Individual
MRS. MARY THERESA JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
149 E MAIN ST, ANDOVER, OH 44003-9479
(440) 293-5555
(440) 293-6643
Mailing address
149 E MAIN ST, ANDOVER, OH 44003-9479
(440) 293-5555
(440) 293-6643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NP 08421
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615450
—
OH
Enumeration date
11/08/2005
Last updated
11/15/2007
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