Individual
DAWANYA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 GARVIN RD, DAYTON, OH 45405-2006
(937) 673-2147
Mailing address
3080 GARVIN RD, DAYTON, OH 45405-2006
(937) 673-2147
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401178801210
OH
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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