MEDICARE: TONYA LYNN FUSKO

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1679139455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA LYNN FUSKO

Provider Business Mailing Address
First Line	:	805 N MAIN ST REAR
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2010
Country	:	US
Telephone Number	:	330-305-9500
Fax Number	:	330-305-9502

Provider Business Practice Location Address
First Line	:	805 N MAIN ST REAR
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2010
Country	:	US
Telephone Number	:	330-305-9500
Fax Number	:	330-305-9502

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	05/16/2019

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Directions to “ TONYA LYNN FUSKO ” Practice Location

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