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1194107821
JERUSHA THACKER
DAYTONA BEACH, FL
NPI
1194107821
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-06-18
Last Update Date
2015-06-18
Business Address
-- JERUSHA THACKER
259 BILL FRANCE BLVD. STE 200
DAYTONA BEACH, FL 32174
Phone number: 386-868-1992
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Mailing Address
-- JERUSHA THACKER
510 S. BEACH STREET APT 1
ORMOND BEACH, FL 32174
Phone number:
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