Individual
JACOB WHITE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 W LONG ST, COLUMBUS, OH 43215-2815
(614) 225-0980
Mailing address
570 RUSSELL RD APT 5, MANSFIELD, OH 44903-1900
(419) 961-5745
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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