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Individual

JENNY LEE GUEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-8206
Mailing address
4233 BEECHGROVE DR, GROVE CITY, OH 43123-3315
(304) 312-2950

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34-00-9617
OH
207P00000X
Emergency Medicine Physician
58-002216
OH
207P00000X
Emergency Medicine Physician
806
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000636641
ANTHEM BLUE CROSS BLUE SHIELD
OH
05
2994121
OH
Enumeration date
05/07/2007
Last updated
04/20/2011
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