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Individual

JONATHAN SHADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
STNA.

Contact information

Practice address
5866 ALBANY TRCE, WESTERVILLE, OH 43081-8890
(614) 772-7012
Mailing address
5866 ALBANY TRCE, WESTERVILLE, OH 43081-8890
(614) 772-7012

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401229350411
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3151664
OH
Enumeration date
10/29/2014
Last updated
10/29/2014
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