Most Relevant Information
Provider Data
| NPI Number: | 1003470519 |
| Provider Name: | JEANNIE DELORICE MICHAELS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/30/2019 |
| Last Updated: | 04/30/2019 |
Provider Practice Location
1528 CENTRAL AVE
SANDUSKY
OH
448703201
Practice Location Phone/Fax
| Phone: | 4192397113 |
| Fax: |
Provider Mailing Location
1528 CENTRAL AVE
SANDUSKY
OH
448703201
Provider Mailing Phone/Fax
| Phone: | 4192397113 |
| Fax: |