Individual
DR. RONALD J MISTUR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
32730 WALKERS ROAD, #I 5, AVON LAKE, OH 44012
(440) 933-8770
(440) 933-8991
Mailing address
32730 WALKERS ROAD, #I 5, AVON LAKE, OH 44012
(440) 933-8770
(440) 933-8991
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1813
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000131040
ANTHEM
OH
Enumeration date
02/13/2006
Last updated
07/08/2007
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