Orville C Tackett
Community Health Worker in South Point, OH. Individual provider (NPI-1).
NPI number1407449366
StatusActive
Last updated in NPPESFeb 11, 2021
Details
- NPI
- 1407449366
- Entity type
- Individual (NPI-1)
- Name
- Orville C Tackett
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 11, 2021
- Certification date
- Feb 11, 2021
- Last updated
- Feb 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
3973 County Road 15South Point, OH 45680-7593
Phone 740-414-8088
Mailing address
3973 County Road 15South Point, OH 45680-7593
Phone 740-414-8088
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