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Individual

JEROME ROBERT VONDERHAAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
103 LANDMARK DR, SIUTE 380, BELLEVUE, KY 41073-1393
(859) 392-3970
Mailing address
1617 HILLTREE DR, CINCINNATI, OH 45255-3200
(513) 474-8442

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
1561
OH
174400000X
Specialist
Primary
R2471
KY

Other

Enumeration date
08/05/2006
Last updated
07/08/2007
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