Individual
JAKE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1081 COUNTRY CLUB RD, COLUMBUS, OH 43227-1481
(610) 944-4082
Mailing address
1081 COUNTRY CLUB RD, COLUMBUS, OH 43227-1481
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005582
OH
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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