Individual
JEFFREY GLAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1139 E GARFIELD RD, AURORA, OH 44202-7755
(440) 382-2399
Mailing address
1139 E GARFIELD RD, AURORA, OH 44202-7755
(440) 382-2399
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430148
—
OH
Enumeration date
04/30/2021
Last updated
04/30/2021
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