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Individual

JEFFREY ANTOINE SMALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4042 GARDEN PARK DR, TOLEDO, OH 43613-4043
(419) 490-3711
Mailing address
4042 GARDEN PARK DR, TOLEDO, OH 43613-4043
(419) 490-3711

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
SN396250
OH

Other

Enumeration date
05/11/2024
Last updated
05/11/2024
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