| LCA CASE NUMBER | I-200-21076-154447 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-17 |
| DECISION DATE | 2021-03-24 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-04-01 |
| END DATE | 2024-03-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| LCA CASE EMPLOYER NAME | Holzer Medical Center - Jackson |
| EMPLOYER ADDRESS1 | 500 Burlington Road |
| EMPLOYER CITY | Jackson |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 45640 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17404463263 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Siders |
| EMPLOYER POC FIRST NAME | Mandy |
| EMPLOYER POC MIDDLE NAME | Dawn |
| EMPLOYER POC JOB TITLE | Physician Practice Integration, Retention, Locum Recruitment |
| EMPLOYER POC ADDRESS 1 | 100 Jackson Pike |
| EMPLOYER POC CITY | Gallipolis |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 45631 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17404463263 |
| EMPLOYER POC EMAIL | msiders@holzer.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Hoyt |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | Wayne |
| AGENT ATTORNEY ADDRESS1 | 200 Civic Center Drive |
| AGENT ATTORNEY ADDRESS2 | Suite 1200 |
| AGENT ATTORNEY CITY | Columbus |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 43215 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16144622650 |
| AGENT ATTORNEY EMAIL ADDRESS | mhoyt@bakerlaw.com |
| LAWFIRM NAME BUSINESS NAME | Baker & Hostetler LLP |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 500 Burlington Road |
| LCA CASE WORKLOC1 CITY | Jackson |
| WORKSITE COUNTY | JACKSON |
| LCA CASE WORKLOC1 STATE | OH |
| WORKSITE POSTAL CODE | 45640 |
| LCA CASE WAGE RATE FROM | 83678 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 83678 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
