Individual
MICHAEL JEFFREY WAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3683 HERMOSA DR, DAYTON, OH 45416-1146
(937) 321-6005
Mailing address
3683 HERMOSA DR, DAYTON, OH 45416-1146
(937) 321-6005
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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