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General NPI Number Information
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NPI Number | 1770472409
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Entity Type | Individual
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Provider Name | ZANDER CREED
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Gender | Male
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 4692 CAMP GROVE RD SE
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-8714
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Country | US
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Telephone | 937-661-5683
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Fax |
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Provider Business Mailing Address
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Address Line | 324 GREGG ST
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-1450
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Country | US
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Telephone | 740-505-8453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | VM594577
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License Number State | OH
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