Organization
LICKING MEMORIAL PROFESSIONAL CORP.
Active
Other names
Licking Memorial Family Practice Licking Valley
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MONTAGNESE (EXECUTIVE V.P.)
(740) 348-4000
Entity
Organization
Contact information
Practice address
2181 W HIGH ST, NEWARK, OH 43055-8917
(740) 348-1720
(740) 348-1726
Mailing address
2181 W HIGH ST, NEWARK, OH 43055-8917
(740) 348-1720
(740) 348-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/18/2006
Last updated
08/22/2020
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