Individual
MR. JOHN E PROKOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
840 N LAKE ST, MADISON, OH 44057-2948
(440) 428-0444
Mailing address
2850 S RIDGE RD, PERRY, OH 44081-9670
(440) 428-0444
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.013570
OH
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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