Independent Provider
NPI #1821217308 in S Charleston, Ohio
Provider Information
- NPI Number
- 1821217308
- Entity Type
- Organization
- Organization Name
- Independent Provider
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Apr 24, 2007
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 2273 NEWLOVE RD
- City
- S Charleston
- State
- Ohio
- ZIP Code
- 45368-9732
- Phone
- (937) 324-4438
Authorized Official
- Name
- MRS. WENDY SUE CAPPER
- Title
- INDEPENDENT PROVIDER
- Phone
- (937) 324-4438
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
| Exclusive Provider Organization |
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