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1750517793
PROVIDIAN
MORAINE, OH
NPI
1750517793
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Entity Type
Organization
Authorized Contact
SHONDALE NICOLE ATKINSON
C.E.O.
937-603-6643
Organization Subpart ?
Yes
Primary Taxonomy
251K00000X Public Health or Welfare
Enumeration Date
2009-06-04
Last Update Date
2009-06-04
Business Address
PROVIDIAN
2844 E RIVER RD
MORAINE, OH 45439-1538
Phone number: 937-603-6643
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Mailing Address
PROVIDIAN
402 KATY LN
ENGLEWOOD, OH 45322-2302
Phone number: 937-603-6643
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