STACY WAYNE JEFFERSON

GEORGETOWN, OH
NPI1861645574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: OH  PN127734 IV)
Enumeration Date2008-10-25
Last Update Date2008-10-25
Business Address
Mr. STACY WAYNE JEFFERSON LPN-IV
432 N GREEN ST
GEORGETOWN, OH 45121-1011
Phone number: 937-213-0588
Mailing Address
Mr. STACY WAYNE JEFFERSON LPN-IV
432 N GREEN ST
GEORGETOWN, OH 45121-1011
Phone number: 937-213-0588