Individual
JACOB M PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 GARDENVIEW ST, KENT, OH 44240-3327
(330) 907-4076
Mailing address
1010 GARDENVIEW ST, KENT, OH 44240-3327
(330) 907-4076
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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