Organization
LICKING MEMORIAL PROFESSIONAL CORP
Active
Other names
Licking Memorial Family Practice Johnstown
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MONTAGNESE (EXECUTIVE V.P)
(740) 348-4000
Entity
Organization
Contact information
Practice address
151 WOODGATE DR, JOHNSTOWN, OH 43031-1198
(740) 348-1810
(740) 348-1811
Mailing address
151 WOODGATE DR, JOHNSTOWN, OH 43031-1198
(740) 348-1810
(740) 348-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/10/2006
Last updated
08/22/2020
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