Provider Demographics
NPI:1659058287
Name:LAY, JOHN WILLARD JR
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLARD
Last Name:LAY
Suffix:JR
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 1:10414 STATE ROUTE 227
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45311-8639
Mailing Address - Country:US
Mailing Address - Phone:937-533-7866
Mailing Address - Fax:
Practice Address - Street 1:10414 STATE ROUTE 227
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45311-8639
Practice Address - Country:US
Practice Address - Phone:937-533-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide