Individual
MR. KENNETH ROY MAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 493-4443
Mailing address
10930 CLAY ST, MONTVILLE, OH 44064-9702
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
—
—
363A00000X
Physician Assistant
Primary
50.003940RX
OH
Other
Enumeration date
06/12/2007
Last updated
09/11/2024
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