Individual
JONATHAN OLLENNU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1628 CATALPA RD, 1628 CATALPA RD, CLEVELAND, OH 44112-1007
(216) 324-9311
(216) 938-7983
Mailing address
1628 CATALPA RD, CLEVELAND, OH 44112-1007
(216) 324-9311
(216) 938-7983
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2906154
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2906154
—
OH
Enumeration date
06/28/2016
Last updated
06/28/2016
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