Individual
JAQUON ANDRE MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 FERNDALE AVE, YOUNGSTOWN, OH 44511-3210
(330) 716-6710
Mailing address
630 FERNDALE AVE, YOUNGSTOWN, OH 44511-3210
(330) 716-6710
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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