Individual
MR. RONALD E WOLLUM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1416 W 1ST ST, SPRINGFIELD, OH 45504
(937) 322-1700
(937) 322-8070
Mailing address
3070 PRESIDENTIAL DR, SUITE 200, FAIRBORN, OH 45324-6293
(937) 429-2160
(937) 426-5663
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50002301
OH
363A00000X
Physician Assistant
PA9106675
FL
Other
Enumeration date
05/25/2006
Last updated
08/23/2018
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