| Licking Memorial Professional Corp. | |
|
96 Integrity Drive H. Hebron OH 43025 | |
| (740) 348-7930 | |
| (740) 348-7931 |
| Full Name | Licking Memorial Professional Corp. |
|---|---|
| Speciality | Family Medicine |
| Location | 96 Integrity Drive, Hebron, Ohio |
| Authorized Official Name and Position | Robert A. Montagnese (EXECUTIVE V.P.) |
| Authorized Official Contact | 7403484000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Professional Corp. 96 Integrity Drive Hebron OH 43025 Ph: (740) 348-7930 | Licking Memorial Professional Corp. 96 Integrity Drive H. Hebron OH 43025 Ph: (740) 348-7930 |
| NPI Number | 1689690661 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689690661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |