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Individual

JESSICA LYNN PFOUTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
121 N MAIN ST, COVINGTON, OH 45318-1317
(937) 214-0315
Mailing address
121 N MAIN ST, COVINGTON, OH 45318-1317

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
SX612097
OH

Other

Enumeration date
09/18/2025
Last updated
09/18/2025
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