Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 29689 | NE |
Y | 207Q00000X | Family Doctor | 35.142032 | OH |
NPI | 1003296302 |
---|---|
Provider Name | Claire Hendrix |
First Address | Liberty Township, OH 45044-9319 |
Second Address | Liberty Township, OH 45044-9319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2015 |
Last Update Date | 12/08/2021 |