Individual
JESSICA MARIE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 DEEDS RD, GRANVILLE, OH 43023-9690
(614) 301-5925
Mailing address
1703 DEEDS RD, GRANVILLE, OH 43023-9690
(614) 301-5925
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
4506150
OH
376J00000X
Homemaker
Primary
4506150
OH
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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