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1922407501
TELETHA PROVITT
REYNOLDSBURG, OH
NPI
1922407501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OH pn148847m-iv)
Enumeration Date
2014-08-19
Last Update Date
2014-08-19
Business Address
-- TELETHA PROVITT
2598 CASTINE WAY
REYNOLDSBURG, OH 43068-4153
Phone number: 614-893-8798
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Mailing Address
-- TELETHA PROVITT
2598 CASTINE WAY
REYNOLDSBURG, OH 43068-4153
Phone number:
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