Provider Demographics
NPI:1619751096
Name:YOHA, MARK A
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:YOHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 CHEVY CHASE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1549
Mailing Address - Country:US
Mailing Address - Phone:419-571-5288
Mailing Address - Fax:
Practice Address - Street 1:763 COUNTY LINE RD LOT 15
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-1207
Practice Address - Country:US
Practice Address - Phone:419-571-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide