Individual
COREY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2217 E 79TH ST, CLEVELAND, OH 44103-4909
(216) 820-8333
Mailing address
2217 E 79TH ST, CLEVELAND, OH 44103-4909
(216) 820-8333
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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