Individual
NATHANIEL ALTON JANEZIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 E 47TH ST, ASHTABULA, OH 44004-6121
(716) 848-0989
Mailing address
1801 E 47TH ST, ASHTABULA, OH 44004-6121
(716) 848-0989
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401266610711
OH
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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