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General NPI Number Information
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NPI Number | 1235370297
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Entity Type | Organization
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Legal Business Name | JOANN M GOTTSCHLING
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 605 S TRIMBLE RD STE. A
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City | MANSFIELD
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State | OH
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Zip | 44906-4112
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Country | US
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Telephone | 419-756-0766
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Fax | 419-756-0701
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Provider Business Mailing Address
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Address Line | 605 S TRIMBLE RD STE. A
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City | MANSFIELD
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State | OH
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Zip | 44906-4112
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Country | US
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Telephone | 419-756-0766
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Fax | 419-756-0701
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Authorized Official
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Title or Position | SUPPLIER/FITTER
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Name | MRS. JOANN M GOTTSCHLING
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Credential | DME/FITTER
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Telephone | 419-756-0766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 70050983
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License Number State | OH
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