Individual
BERTHA E JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 WINDING RIDGE DR, DAYTON, OH 45415-2819
(937) 977-4153
Mailing address
108 WINDING RIDGE DR, DAYTON, OH 45415-2819
(937) 977-4153
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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