Licking Memorial Professional Corp.

NPI #1487688545 in Heath, Ohio

Provider Information

NPI Number: 1487688545
Entity Type: Organization
Organization Name: Licking Memorial Professional Corp.
Primary Specialty: Family Medicine
Enumeration Date: Jul 11, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 687 HOPEWELL DR
Address 2: SUITE2
City: Heath
State: Ohio
ZIP Code: 43056-1579
Phone: (740) 348-7915

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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