Individual
BREYON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3132 IDLEWOOD AVE, YOUNGSTOWN, OH 44511-3138
(330) 423-3523
Mailing address
3132 IDLEWOOD AVE, YOUNGSTOWN, OH 44511-3138
(330) 423-3523
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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