Individual
JACK MATTMULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1750 HIGHLAND RD STE 7B, TWINSBURG, OH 44087-2244
(330) 405-7040
(330) 405-7044
Mailing address
4390 LINDA DR, VERMILION, OH 44089-3404
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03116103
OH
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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