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1669008157
JONATHAN BRENT ORTH
WATSON, IL
NPI
1669008157
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2020-03-17
Last Update Date
2020-03-17
Business Address
JONATHAN BRENT ORTH
5118 N 1350TH ST
WATSON, IL 62473-2271
Phone number: 404-783-2146
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Mailing Address
JONATHAN BRENT ORTH
5118 N 1350TH ST
WATSON, IL 62473-2271
Phone number: 404-783-2146
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