Individual
MISS INDIA RACHELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
829 17TH AVE, MIDDLETOWN, OH 45044-5636
(513) 422-0676
Mailing address
829 17TH AVE, MIDDLETOWN, OH 45044-5636
(513) 422-0676
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400465690305
OH
Other
Enumeration date
01/07/2011
Last updated
01/07/2011
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