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Individual

JALIA R WORTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2503 ARLENE AVE, DAYTON, OH 45406-1349
(937) 397-0072
Mailing address
2503 ARLENE AVE, DAYTON, OH 45406-1349
(937) 397-0072

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
57188889
OH
Enumeration date
11/11/2021
Last updated
11/11/2021
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