Most Relevant Information
Provider Data
| NPI Number: | 1003533852 |
| Provider Name: | SUEANN JEFFERDS |
| Entity Type: | Individual |
| Taxonomy Code: | 171WH0202X |
| Specialty: | Contractor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/24/2022 |
| Last Updated: | 10/24/2022 |
Provider Practice Location
5146 HALLGATE AVE
TOLEDO
OH
436123020
Practice Location Phone/Fax
| Phone: | 4198069908 |
| Fax: |
Provider Mailing Location
5146 HALLGATE AVE
TOLEDO
OH
436123020
Provider Mailing Phone/Fax
| Phone: | 4198069908 |
| Fax: |