Individual
JACKSON LEE SLUPEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STNA
Contact information
Practice address
9876 MAPLE DR, LOVELAND, OH 45140-1601
(513) 488-3942
Mailing address
9876 MAPLE DR, LOVELAND, OH 45140-1601
(513) 488-3942
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401066230410
OH
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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