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Individual

MR. DOUGLAS PATRICK VONDRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3090 YOAKAM RD, LIMA, OH 45806-1144
(567) 204-4365
Mailing address
3090 YOAKAM RD, LIMA, OH 45806-1144
(567) 204-4365

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
910001044390
OH
Enumeration date
06/09/2021
Last updated
06/09/2021
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