Individual
MR. JACOB T BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
35 LORI LN APT 1, AMELIA, OH 45102-2462
(513) 748-1972
Mailing address
2289 BETHEL NEW RICHMOND RD, BETHEL, OH 45106-9527
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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