Individual
JACKLYN TELLEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3160 SWOPE ST, TRINWAY, OH 43842-7729
(740) 319-7704
Mailing address
3160 SWOPE ST, TRINWAY, OH 43842-7729
(740) 319-7704
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
TC877796
OH
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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