Jaidyn Marie Mavis, INDEPENDENT PROVIDER
NPI #1063289528 in Wapakoneta, Ohio
Provider Information
- NPI Number
- 1063289528
- Entity Type
- Individual
- Name
- Jaidyn Marie Mavis, INDEPENDENT PROVIDER
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Home Health
- Credential
- INDEPENDENT PROVIDER
- Enumeration Date
- Dec 5, 2023
- Last Updated
- Dec 5, 2023
Practice Location
- Address
- 612 BELLEFONTAINE ST
- City
- Wapakoneta
- State
- Ohio
- ZIP Code
- 45895-2016
- Phone
- (567) 356-9812
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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