Provider Demographics
NPI:1366121428
Name:JARES, THOMAS H
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:JARES
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 1:6861 BALLASH RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8889
Mailing Address - Country:US
Mailing Address - Phone:440-915-4357
Mailing Address - Fax:
Practice Address - Street 1:4790 PORTER RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-2527
Practice Address - Country:US
Practice Address - Phone:440-915-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver