Individual
JARED WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3183 W SIEBENTHALER AVE STE C, DAYTON, OH 45406-1849
(937) 203-0687
Mailing address
3183 W SIEBENTHALER AVE STE C, DAYTON, OH 45406-1849
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5718935
—
OH
Enumeration date
05/08/2022
Last updated
05/08/2022
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