Organization
LICKING MEMORIAL PROFESSIONAL CORP
Active
Other names
Licking Memorial Family Practice Pataskala
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A. MONTAGNESE (EXECUTIVE V.P.)
(740) 348-4000
Entity
Organization
Contact information
Practice address
1 HEALTHY PL, SUITE 101, PATASKALA, OH 43062-7067
(740) 348-1900
(740) 348-1901
Mailing address
1 HEALTHY PL, SUITE 101, PATASKALA, OH 43062-7067
(740) 348-1900
(740) 348-1901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/10/2006
Last updated
08/22/2020
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