Individual
MR. JOHN MARTIN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
453 WEST MAIN STREET, MOUNT ORAB, OH 45154
(937) 783-4535
(937) 783-0009
Mailing address
661 WEST MAIN STREET, BLANCHESTER, OH 45107
(937) 783-4535
(937) 783-0009
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
015389
OH
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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