Individual
JONATHAN DALE NATICCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9110 MENTOR AVE, MENTOR, OH 44060-6404
(440) 701-8030
Mailing address
17685 CREEKSIDE DR, CHAGRIN FALLS, OH 44023-5452
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.009705
OH
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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