Waters, Jack

Waters, Jack is an individual health care provider with primary practice located at 15221 State Route 772 , Piketon OH 45661. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Waters, Jack can be contacted via phone (740) 493-4260.

Contact Information

Primary practice address
15221 State Route 772 Piketon OH 45661
Phone: (740) 493-4260
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDCIII.161114 Ohio

Profile Details

NPI number 1952820482
LBN Legal business name Waters, Jack
Credentials LCDC-III, QMHS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2017
Last updated Sep 15th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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