Individual
MRS. AMY LYNN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
812 COUNTY ROAD 24 N, DE GRAFF, OH 43318-9716
(937) 539-2568
Mailing address
812 COUNTY ROAD 24 N, DE GRAFF, OH 43318-9716
(937) 539-2568
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
4601587
OH
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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