Individual
EVAN JAMES JACKELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3721 HALLIE LN, EAU CLAIRE, WI 54703-1185
(715) 533-9460
Mailing address
3721 HALLIE LN, EAU CLAIRE, WI 54703-1185
(715) 533-9460
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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