Individual
CARL'AVERIS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1646 WESLEYAN RD # B, DAYTON, OH 45406-3606
(937) 985-2275
Mailing address
1646 WESLEYAN RD # B, DAYTON, OH 45406-3606
(937) 985-2275
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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