Healthcare Provider Details

I. General information

NPI: 1821952995
Provider Name (Legal Business Name): JEREMY LOTTMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 E SEMINARY ST
NORWALK OH
44857-2121
US

IV. Provider business mailing address

4 E SEMINARY ST
NORWALK OH
44857-2121
US

V. Phone/Fax

Practice location:
  • Phone: 567-424-6003
  • Fax: 855-429-4118
Mailing address:
  • Phone: 567-424-6003
  • Fax: 855-429-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: