Licking Memorial Professional Corp.

NPI #1235159674 in Pataskala, Ohio

Provider Information

NPI Number: 1235159674
Entity Type: Organization
Organization Name: Licking Memorial Professional Corp.
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Jul 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1 HEALTHY PL
Address 2: SUITE 103
City: Pataskala
State: Ohio
ZIP Code: 43062-7067
Phone: (740) 348-1920

Authorized Official

Name: ROBERT A. MONTAGENSE
Title: EXECUTIVE V.P.
Phone: (740) 348-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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