Individual
JASPER EVANS OMOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7015 BASCOMBE DR, HUBER HEIGHTS, OH 45424-2905
(937) 344-4451
Mailing address
7015 BASCOMBE DR, HUBER HEIGHTS, OH 45424-2905
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.373941
OH
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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