Most Relevant Information
Provider Data
| NPI Number: | 1003694514 |
| Provider Name: | JEANISE MONIFA NORTH |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/18/2023 |
| Last Updated: | 09/18/2023 |
Provider Practice Location
436 BREADEN ST
YOUNGSTOWN
OH
445021626
Practice Location Phone/Fax
| Phone: | 3307660504 |
| Fax: |
Provider Mailing Location
436 BREADEN ST
YOUNGSTOWN
OH
445021626
Provider Mailing Phone/Fax
| Phone: | 3307660504 |
| Fax: |