Individual
JESSICA LANE HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
325 EAST PORTER ST., APT. 5, MALVERN, OH 44644
(330) 209-3802
Mailing address
PO BOX 685, MALVERN, OH 44644-0685
(330) 209-3802
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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