Organization
JCC, LLC
Active
Other names
PDI DAYTON
Organization subpart
No
Provider details
NPI number
Authorized official
JACK CHAMPNEY CORNELL (PRESIDENT/CEO)
(440) 223-8848
Entity
Organization
Contact information
Practice address
5692 FAR HILLS AVE, SUITE 1H, DAYTON, OH 45429-2202
(937) 438-3384
(937) 438-3394
Mailing address
15371 HEMLOCK POINT ROAD, CHAGRIN FALLS, OH 44022-3801
(855) 734-2645
(855) 734-2645
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3009112
—
OH
Enumeration date
12/19/2008
Last updated
04/30/2025
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