Doctor Name: | JEROME ROBERT VONDERHAAR |
NPI Number: | 1265441554 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OTR/L |
License Number: | 1561 |
Business Practice Address: | 103 Landmark Dr Siute 380 Bellevue, KY - 410731393 |
Business Phone Number: | 8593923970 |
Business Fax Number: | |
Mailing Address: | 1617 Hilltree Dr, CINCINNATI |
State: | OH |
Postal Code: | 452553200 |
Phone Number: | 5134748442 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1561 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |