Individual
JACK MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 W SCHROCK RD, A, WESTERVILLE, OH 43081-8702
(614) 891-0005
Mailing address
PO BOX 951603, CLEVELAND, OH 44193-0018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-04-3725
OH
Other
Enumeration date
06/12/2006
Last updated
12/05/2007
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