JACK FOUNTAIN

CANTON, OH
NPI1831347129
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy3747P1801X Technician Personal Care Attendant
Enumeration Date2008-08-29
Last Update Date2008-08-29
Business Address
MR. JACK FOUNTAIN
2232 TIMES AVE SW
CANTON, OH 44706-2116
Phone number: 330-412-7963
Mailing Address
MR. JACK FOUNTAIN
2232 TIMES AVE SW
CANTON, OH 44706-2116
Phone number: 330-412-7963
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