Provider Demographics
NPI:1124623566
Name:JOSEPH, PATTY A
Entity type:Individual
Prefix:
First Name:PATTY
Middle Name:A
Last Name:JOSEPH
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 1:174 EDWARDS ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-2836
Mailing Address - Country:US
Mailing Address - Phone:740-360-7405
Mailing Address - Fax:
Practice Address - Street 1:174 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-2836
Practice Address - Country:US
Practice Address - Phone:740-360-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)