Independent Provider

NPI #1992910863 in Arcanum, Ohio

Provider Information

NPI Number: 1992910863
Entity Type: Organization
Organization Name: Independent Provider
Primary Specialty: Respite Care
Enumeration Date: May 13, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 308 W 1ST ST
City: Arcanum
State: Ohio
ZIP Code: 45304-1167
Phone: (937) 692-8081

Authorized Official

Name: DAVID MARTIN FERGUSON
Title: INDEPENDENT
Phone: (937) 692-8081

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Respite Care	385H00000X	Primary

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