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Individual

ABAGAIL LEE JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9086 BRYANT RD, WINDHAM, OH 44288-9721
(330) 842-2691
Mailing address
9086 BRYANT RD, WINDHAM, OH 44288-9721
(330) 842-2691

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
372600000X
Adult Companion
376J00000X
Homemaker
Primary

Other

Enumeration date
09/25/2024
Last updated
09/25/2024
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