Individual
JONATHAN EDWARD VICHOSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2815 HASTINGS RD, SILVER LAKE, OH 44224-3703
(440) 812-9639
Mailing address
2815 HASTINGS RD, SILVER LAKE, OH 44224-3703
(440) 812-9639
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.007462RX
OH
Other
Enumeration date
03/25/2021
Last updated
06/02/2022
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