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Individual

JULIE A MOENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
1178 PROFESSIONAL DR, VAN WERT, OH 45891-2461
(419) 238-6251
(419) 238-1652
Mailing address
1178 PROFESSIONAL DR, VAN WERT, OH 45891-2461
(419) 238-6251
(419) 238-1652

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50003909
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341380522
TAX ID
OH
Enumeration date
09/24/2013
Last updated
01/27/2016
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