Individual
MR. ANTWAN LAVEE JEFFRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STNA
Contact information
Practice address
616 GAWIL AVE, TOLEDO, OH 43609-1116
(419) 787-0139
Mailing address
616 GAWIL AVE, TOLEDO, OH 43609-1116
(419) 787-0139
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401111130710
OH
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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