Individual
MR. JON RANDAHL WATTERWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 MCBEE RD, SUGARCRK TWP, OH 45305-9747
(937) 367-5982
Mailing address
800 MCBEE RD, SUGARCRK TWP, OH 45305-9747
(937) 367-5982
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
2903791
OH
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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