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NPI Code Detail

MEDICARE: JO ANNE CARSON

MEDICARE: JO ANNE CARSON
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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1710536990
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO ANNE CARSON
Provider Business Mailing Address
First Line : 2460 CHERRY ST
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2667
Country : US
Telephone Number : 419-380-0116
Fax Number : 419-389-6284
Provider Business Practice Location Address
First Line : 2460 CHERRY ST
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2667
Country : US
Telephone Number : 419-380-0116
Fax Number : 419-389-6284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2019
Last Update Date : 09/10/2019

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