Individual
JAKE PROTIVNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PC
Contact information
Practice address
3920 LOVERS LN, RAVENNA, OH 44266-4200
(330) 673-1347
(330) 678-3677
Mailing address
5982 RHODES RD, KENT, OH 44240-4128
(330) 673-1347
(330) 678-3677
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C7727
OH
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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