Individual
JESSE GUARDADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2625 VASSAR AVE, LORAIN, OH 44053-2359
(440) 897-4866
Mailing address
2625 VASSAR AVE, LORAIN, OH 44053-2359
(440) 897-4866
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
4705851
OH
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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