Individual
JESUS ALFREDO MONTES RODARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13207 RAVENNA RD, CHARDON, OH 44024-7032
(440) 285-6000
Mailing address
30911 ROOSEVELT RD, WICKLIFFE, OH 44092-1030
(859) 409-9788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006984
OH
Other
Enumeration date
06/05/2021
Last updated
06/05/2021
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