Individual
JACKIE VENCILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3551 N RIDGE RD E, ASHTABULA, OH 44004-4313
(440) 998-4014
(440) 998-4017
Mailing address
3551 N RIDGE RD E, ASHTABULA, OH 44004-4313
(440) 969-0492
(440) 998-4017
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SC6346
OH
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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