Individual
JEANETTE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1852 PEACOCK LN, HOLLAND, OH 43528-9282
(419) 868-6086
Mailing address
1852 PEACOCK LN, HOLLAND, OH 43528-9282
(419) 868-6086
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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