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1396295168
JAMES SAMPLE
DOVER, OH
NPI
1396295168
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.161142)
Enumeration Date
2016-10-05
Last Update Date
2016-10-05
Business Address
-- JAMES SAMPLE CDCA
897 E IRON AVE
DOVER, OH 44622-2030
Phone number: 330-343-5555
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Mailing Address
-- JAMES SAMPLE CDCA
897 E IRON AVE
DOVER, OH 44622-2030
Phone number: 330-343-5555
Copy
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