Provider Demographics
NPI:1790372415
Name:BAIR, MARGO A
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:A
Last Name:BAIR
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 1:145 W CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2942
Mailing Address - Country:US
Mailing Address - Phone:330-705-4486
Mailing Address - Fax:
Practice Address - Street 1:145 W CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2942
Practice Address - Country:US
Practice Address - Phone:330-705-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide