Provider Demographics
NPI:1497595870
Name:WHITING, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:WHITING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 CALL RD
Mailing Address - Street 2:
Mailing Address - City:CROWN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45623-9144
Mailing Address - Country:US
Mailing Address - Phone:740-479-8500
Mailing Address - Fax:
Practice Address - Street 1:294 CALL RD
Practice Address - Street 2:
Practice Address - City:CROWN CITY
Practice Address - State:OH
Practice Address - Zip Code:45623-9144
Practice Address - Country:US
Practice Address - Phone:740-479-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant