Individual
JASON MONDVILLE-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
810 E MANHATTAN BLVD, TOLEDO, OH 43608-1471
(419) 729-2907
(419) 729-2834
Mailing address
810 E MANHATTAN BLVD, TOLEDO, OH 43608-1471
(419) 729-2907
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
09315184
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09315184
OHIO BOARD OF PHARMACY
OH
01
—
30128541
PTCB
—
Enumeration date
04/15/2021
Last updated
04/15/2021
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