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Individual

JONATHAN EARL WALLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7763 STATE ROUTE 303, WINDHAM, OH 44288-9791
(330) 442-2813
Mailing address
7763 STATE ROUTE 303, WINDHAM, OH 44288-9791
(330) 442-2813

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
111111
OH

Other

Enumeration date
01/24/2025
Last updated
01/24/2025
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