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Individual

JACKIE D LALLATHIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4739 LEAP CT, HILLIARD, OH 43026-1177
(614) 517-9406
Mailing address
4739 LEAP CT, HILLIARD, OH 43026-1177
(614) 517-9406

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
134632
OH

Other

Enumeration date
09/07/2011
Last updated
09/07/2011
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