Individual
JARED PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2624 LEXINGTON AVE, SPRINGFIELD, OH 45505
(937) 328-5300
(937) 322-4900
Mailing address
2624 LEXINGTON AVE, SPRINGFIELD, OH 45505-2620
(937) 328-5300
(937) 322-4900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
CDCA.164909
OH
175T00000X
Peer Specialist
Primary
00678
OH
Other
Enumeration date
11/03/2017
Last updated
10/04/2019
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