| NPI | 1669547824 |
|---|---|
| Doing Business As | LICKING MEMORIAL PEDIATRICS EAST |
| Entity Type | Organization |
| Authorized Contact | ROBERT A. MONTAGNESE Credentialing Coordinator 740-348-4027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |