Individual
JACQUELYN CONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3020 PHOTOS DR, TOLEDO, OH 43613-2435
(419) 473-8268
Mailing address
10050 STEVENSON DR, TEMPERANCE, MI 48182-9715
(419) 320-2124
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
131358
OH
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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