Individual
MR. JACOB A BLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
63 ORCHARD AVE, RITTMAN, OH 44270-1209
(330) 465-7384
Mailing address
63 ORCHARD AVE, RITTMAN, OH 44270-1209
(330) 465-7384
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN.410758
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0020166
OH
Other
Enumeration date
11/07/2013
Last updated
09/30/2020
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