Licking Memorial Professional Corp.

NPI #1689690661 in Hebron, Ohio

Provider Information

NPI Number: 1689690661
Entity Type: Organization
Organization Name: Licking Memorial Professional Corp.
Primary Specialty: Family Medicine
Enumeration Date: Jul 14, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 96 INTEGRITY DRIVE
Address 2: H.
City: Hebron
State: Ohio
ZIP Code: 43025
Phone: (740) 348-7930

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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