Individual
MS. JENNIFER ANITA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
804 S MUMAUGH RD, LIMA, OH 45804-3569
(419) 225-9040
Mailing address
680 APPLE BLOSSOM LN, ARLINGTON, OH 45814-9669
(419) 365-0312
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3022
OH
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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