Individual
JEANNITTA CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(419) 528-5993
Mailing address
680 PARK AVE W, MANSFIELD, OH 44906-3706
(415) 528-5993
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
586296
OH
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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