Most Relevant Information
Provider Data
| NPI Number: | 1003542051 |
| Provider Name: | SALLY MAE COTEREL CHANEY SOLE PROPRIETOR |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/30/2022 |
| Last Updated: | 07/30/2022 |
Provider Practice Location
6154 BLACK RUN RD
CHILLICOTHE
OH
456019155
Practice Location Phone/Fax
| Phone: | 7408045528 |
| Fax: |
Provider Mailing Location
6154 BLACK RUN RD
CHILLICOTHE
OH
456019155
Provider Mailing Phone/Fax
| Phone: | 7408045528 |
| Fax: |