Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Parent organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Other names
Licking Memorial Pataskala Specialties
Organization subpart
Yes
Provider details
NPI number
Legal business name
LICKING MEMORIAL PROFESSIONAL CORPORATION
Authorized official
CYNTHIA WEBSTER (VP REVENUE CYCLE & INTERIM VP FINAN)
(740) 348-4027
Entity
Organization
Contact information
Practice address
1 HEALTHY PL STE 202, PATASKALA, OH 43062-7067
(740) 348-1935
(740) 348-1936
Mailing address
1 HEALTHY PL STE 202, PATASKALA, OH 43062-7067
(740) 348-1935
(740) 348-1936
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34008308
OH
Other
Enumeration date
03/05/2009
Last updated
03/06/2009
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