Individual
JONATHAN SUTERMEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3260 GAMBIT SQ, DAYTON, OH 45449-3513
(937) 367-5542
Mailing address
3260 GAMBIT SQ, DAYTON, OH 45449-3513
(937) 367-5542
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052968
—
OH
Enumeration date
07/09/2014
Last updated
07/09/2014
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