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1104304450
CLARENCE A JACKSON
YOUNGSTOWN, OH
NPI
1104304450
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: OH 0000000)
Enumeration Date
2018-07-30
Last Update Date
2018-07-30
Business Address
CLARENCE A JACKSON
8440 MARKET ST
YOUNGSTOWN, OH 44512-6703
Phone number: 330-965-9999
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Mailing Address
CLARENCE A JACKSON
8440 MARKET ST
YOUNGSTOWN, OH 44512-6703
Phone number: 330-965-9999
Copy
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