Provider Demographics
NPI:1710728233
Name:ZARTMAN, JUSTIN TYLER
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:TYLER
Last Name:ZARTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27710 BRADNER RD
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43447-9424
Mailing Address - Country:US
Mailing Address - Phone:419-494-7368
Mailing Address - Fax:
Practice Address - Street 1:27710 BRADNER RD
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:OH
Practice Address - Zip Code:43447-9424
Practice Address - Country:US
Practice Address - Phone:419-494-7368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X, 372600000X
OHSB471077172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver