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Individual

JACOB K RASANOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
7007 POWERS BLVD, PARMA, OH 44129-5437
(440) 350-0832
(440) 579-0191
Mailing address
7757 AUBURN RD, STE 15, PAINESVILLE, OH 44077-9604
(440) 350-0832
(440) 354-7420

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000283
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0217141
OH
Enumeration date
06/02/2016
Last updated
03/31/2020
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