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Individual

JAY TWARDOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1358 ORCHARD RUN DR, LEBANON, OH 45036-9251
(513) 520-7267
Mailing address
1358 ORCHARD RUN DR, LEBANON, OH 45036-9251

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0960474
OH
Enumeration date
08/15/2014
Last updated
08/15/2014
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