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Individual

JENNIFER WAMPLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6802 WESTVIEW DR, BRECKSVILLE, OH 44141-2924
(440) 630-9096
(440) 630-9177
Mailing address
6802 WESTVIEW DR, BRECKSVILLE, OH 44141-2924

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0119474
OH
Enumeration date
07/16/2015
Last updated
07/16/2015
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