Most Relevant Information
Provider Data
| NPI Number: | 1003471095 |
| Provider Name: | JESSICA OMEGA SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/05/2019 |
| Last Updated: | 05/05/2019 |
Provider Practice Location
624 E MAIN ST
LANCASTER
OH
431303903
Practice Location Phone/Fax
| Phone: | 6148167467 |
| Fax: |
Provider Mailing Location
1140 3RD ST
LOGAN
OH
431381059
Provider Mailing Phone/Fax
| Phone: | 6148167467 |
| Fax: |