Individual
SHANNON M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4028 VIRA RD, STOW, OH 44224-3637
(330) 645-5655
Mailing address
4028 VIRA RD, STOW, OH 44224-3637
(330) 645-5655
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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