Individual
MRS. JACQULYN SUE SLOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 HOWARD ST, BRIDGEPORT, OH 43912-1126
(740) 635-1535
Mailing address
69713 CRESTVIEW LN, SAINT CLAIRSVILLE, OH 43950-8313
(740) 695-9479
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2068
OH
237700000X
Hearing Instrument Specialist
690
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0890013
—
OH
01
—
900
HEALTH PLAN OF THE UPPER
OH
Enumeration date
09/13/2006
Last updated
07/08/2007
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