Healthcare Provider Details
I. General information
NPI: 1639914658
Provider Name (Legal Business Name): RONALD M DANE CRISIS CALL CTR SPEC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/01/2024
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7976 DAIRY LN
ATHENS OH
45701-9391
US
IV. Provider business mailing address
PO BOX 188
CHILLICOTHEE OH
45601-0188
US
V. Phone/Fax
- Phone: 740-593-5164
- Fax: 740-594-6829
- Phone: 740-773-4366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: