Provider Demographics
NPI:1467008102
Name:JUNTUNEN, ROGER DALE (JD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:DALE
Last Name:JUNTUNEN
Suffix:
Gender:M
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 CHRISTIAN AVE
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2011
Mailing Address - Country:US
Mailing Address - Phone:330-883-0977
Mailing Address - Fax:
Practice Address - Street 1:231 CHRISTIAN AVE
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-2011
Practice Address - Country:US
Practice Address - Phone:330-883-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer