Provider Demographics
NPI:1609604222
Name:HALL, JAMAR DONTE
Entity type:Individual
Prefix:
First Name:JAMAR
Middle Name:DONTE
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 RACHEL ST NW APT 15
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2880
Mailing Address - Country:US
Mailing Address - Phone:330-413-9989
Mailing Address - Fax:
Practice Address - Street 1:1459 RACHEL ST NW APT 15
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2880
Practice Address - Country:US
Practice Address - Phone:330-413-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide