MEDICARE: CHIP DENGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	401317001111	OH

General Provider Information

NPI Number	:	1962085431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIP DENGER

Provider Business Mailing Address
First Line	:	6060 LIVE OAK CT
Second Line	:
City	:	WEST SALEM
State	:	OH
Zip	:	44287-9667
Country	:	US
Telephone Number	:	330-242-2274
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 LIVE OAK CT
Second Line	:
City	:	WEST SALEM
State	:	OH
Zip	:	44287-9667
Country	:	US
Telephone Number	:	330-242-2274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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Directions to “ CHIP DENGER ” Practice Location

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