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1811508914
JACOB TISEVICH
MIAMISBURG, OH
NPI
1811508914
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OH 50.006640RX)
Enumeration Date
2020-08-12
Last Update Date
2020-09-21
Business Address
JACOB TISEVICH PA
2835 MIAMI VILLAGE DR
MIAMISBURG, OH 45342-4916
Phone number: 937-449-0796
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Mailing Address
JACOB TISEVICH PA
6480 HARRISON AVE STE 201
CINCINNATI, OH 45247-7961
Phone number: 513-354-7650
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