Individual
SUEANN JEFFERDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5146 HALLGATE AVE, TOLEDO, OH 43612-3020
(419) 806-9908
Mailing address
5146 HALLGATE AVE, TOLEDO, OH 43612-3020
(419) 806-9908
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0296271
—
OH
Enumeration date
10/24/2022
Last updated
10/24/2022
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