OrganizationActive
Licking Memorial Professional Corp
NPI 1255365102 · Family Medicine Physician · Johnstown, OH
Provider details
- NPI number
- 1255365102
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Montagnese, Executive V.p(740) 348-4000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
151 Woodgate Dr
Johnstown, OH 43031-1198
Phone: (740) 348-1810
Fax: (740) 348-1811
Approximate (ZIP-level) locationGet directions
Mailing address
151 Woodgate Dr
Johnstown, OH 43031-1198
Other names (DBA / former)
- Doing business as
- Licking Memorial Family Practice Johnstown
Registry dates
- Enumerated
- 2006-07-10
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.