Individual
JAIDYN MARIE MAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDER
Contact information
Practice address
612 BELLEFONTAINE ST, WAPAKONETA, OH 45895-2016
(567) 356-9812
Mailing address
612 BELLEFONTAINE ST, WAPAKONETA, OH 45895-2016
(567) 356-9812
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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