Individual
KOOLJOE FREDDY NTIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7650 HOWELL PARK DR, PICKERINGTON, OH 43147-9513
(614) 316-6408
Mailing address
7650 HOWELL PARK DR, PICKERINGTON, OH 43147-9513
(614) 316-6408
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
024423
OH
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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