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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Jack Levine | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| First name | Jack | [sources] | |||
| Last name | Levine | [sources] | |||
| NPI | 1164492922 | [sources] | |||
| Address | 7428 State Route 772, Piketon, OH 45661 | [sources] | |||
| Last change | Last processed | First seen | |||
Medicaid providers sanctioned in West Virginia's Medicaid program.
United States of America · MMIS
For experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| 7428 State Route 772, Piketon, OH 45661 | United States of America | |