Individual
GLORY JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 SHANNON LN, XENIA, OH 45385-2788
(626) 771-3201
Mailing address
1180 SHANNON LN, XENIA, OH 45385-2788
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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