SearchOhio172A00000X

Thisia Jackson

NPI 1184211864 · on the registry since 2020 · sole proprietor

Practice

Address
2190 Ambleside Dr Apt 809
Cleveland, OH 44106
Phone
(216) 609-6469

Registry record

Primary taxonomy
172A00000X
172A00000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-12-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Ohio