Individual
JACKSON PAUL BONFIGLIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
155 5TH ST NE, BARBERTON, OH 44203-3332
(330) 615-3000
Mailing address
3713 CHESTERTON DR, TOLEDO, OH 43615-1173
(419) 708-4565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1182247
OH
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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