Individual
DR. JENNIFER J BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1005 BELLEFONTAINE AVE STE 350, LIMA, OH 45804-2885
(419) 998-8297
(419) 226-8309
Mailing address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34.009127
OH
390200000X
Student in an Organized Health Care Education/Training Program
34.009127
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210254
—
OH
Enumeration date
10/10/2007
Last updated
12/14/2022
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