Provider Demographics
NPI:1245095801
Name:TOMKO, JODY K
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:K
Last Name:TOMKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:K
Other - Last Name:FLORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7817 STONE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8999
Mailing Address - Country:US
Mailing Address - Phone:330-441-1652
Mailing Address - Fax:
Practice Address - Street 1:7817 STONE RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8999
Practice Address - Country:US
Practice Address - Phone:330-441-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty