JACK WATERS

PIKETON, OH
NPI1952820482
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  LCDCIII.161114)
Enumeration Date2017-09-15
Last Update Date2017-09-15
Business Address
JACK WATERS LCDC-III, QMHS
15221 STATE ROUTE 772
PIKETON, OH 45661
Phone number: 740-493-4260
Mailing Address
JACK WATERS LCDC-III, QMHS
4431 MAPLE GROVE RD
CHILLICOTHE, OH 45601-8890
Phone number: 740-703-5507
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