Individual
MR. JON EARL DITMARS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
655 S OAKLEY AVE, COLUMBUS, OH 43204-2920
(614) 351-1408
Mailing address
655 S OAKLEY AVE, COLUMBUS, OH 43204-2920
(614) 351-1408
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
121292
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2620140
—
OH
Enumeration date
08/16/2007
Last updated
08/16/2007
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