Individual
JACOB BATESOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
33200 HEALTH CAMPUS BLVD, AVON, OH 44011-1481
(440) 937-0757
Mailing address
970 GULF RD, ELYRIA, OH 44035-2962
(440) 452-5878
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005773
OH
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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