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Jacob Johnston
NPI 1972175321 · on the registry since 2021
Practice
- Address
- 3543 Providence Trace Dr
Melbourne, KY 41059 - Phone
- (513) 675-2612
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-07-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky