Individual
JILL PATRICIA JUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2546 NW 84TH AVE, ANKENY, IA 50023-9443
(515) 707-5294
Mailing address
2546 NW 84TH AVE, ANKENY, IA 50023-9443
(515) 707-5294
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0843
MANUFACTURING
—
Enumeration date
07/11/2020
Last updated
07/11/2020
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