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Individual

LONDALE DESHAWN ROWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6914 ONYXBLUFF LN, BLACKLICK, OH 43004-8099
(614) 861-8686
Mailing address
6914 ONYXBLUFF LN, BLACKLICK, OH 43004-8099
(614) 861-8686

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
2307980
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2307980
OH
Enumeration date
01/24/2007
Last updated
07/08/2007
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