Individual
JACKIE NIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9940 STATE ROUTE 43, STREETSBORO, OH 44241-4938
(330) 626-1866
Mailing address
9940 STATE ROUTE 43, STREETSBORO, OH 44241-4938
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-3-14295
OH
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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