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Jacob Dale Masters
Meals Provider in Dayton, Ohio
NPI 1073070884

Jacob Dale Masters is a Meals Provider based in West Carrollton, OH. Jacob Dale Masters practices in Dayton, OH. The NPI Number for Jacob Dale Masters is 1073070884 and holds a License No. (Ohio).

The current practice location address for Jacob Dale Masters is 2706 Flowerstone Dr, Dayton, OH and can be reached out via phone at 937-422-8598. You can also correspond with Jacob Dale Masters through the mailing address at 2706 FLOWERSTONE DR, WEST CARROLLTON, OH - 45449-3217 (mailing address contact number: 937-422-8598).

Location: 2706 Flowerstone Dr, Dayton, OH, 45449-3217
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Provider Profile Details
NPI Number
1073070884
Provider Name
Jacob Dale Masters
Credential
Provider Entity Type
Individual
Gender
Male
Address
2706 Flowerstone Dr, Dayton, OH, 45449-3217
Phone Number
937-422-8598
Fax Number
Provider Enumeration Date
02/28/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0317945 05 OH
institution
Provider Business Practice Location Address Details
Address
2706 Flowerstone Dr
City
State
Zip
45449-3217
Phone Number
937-422-8598
Fax Number
person
Provider Business Mailing Address Details
Address
2706 Flowerstone Dr
City
State
Zip
45449-3217
Phone Number
937-422-8598
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Meals
Speciality
-
Taxonomy
License No.
()
Definition
A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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