Provider Information for 1548747157
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ALEX JOHN CLAUSSEN I
Sex: Male
NPI: 1548747157
Last Updated: 2024-04-01
Certification Date: 2024-04-01
Certification Date: 2024-04-01
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1548747157 | ||||||||||||||||
| Enumeration Date | 2018-07-26 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1100 SHAWNEE RD LIMA, OH 45805-3583 United States Phone: 419-999-2010 | Fax:419-999-6284 | ||||||||||||||||
| Primary Practice Address | 4293 MONROE ST TOLEDO, OH 43606-1943 United States Phone: 419-474-6021 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 3953 NAVARRE AVE | ||||||||||||||||
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