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Individual

JACQUELYN ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7521 LOCKWOOD ST, DAYTON, OH 45415-1121
(937) 853-6179
Mailing address
7521 LOCKWOOD ST, DAYTON, OH 45415-1121
(937) 853-6179

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
159776
OH

Other

Enumeration date
08/16/2016
Last updated
08/16/2016
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