Individual
BRANDON JAEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 CLARKE ST APT 209, ATHENS, OH 45701-1549
(740) 590-8240
Mailing address
88 COLUMBUS CIR, ATHENS, OH 45701-1370
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000228274
—
OH
Enumeration date
02/01/2021
Last updated
02/01/2021
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