Individual
BRETZYL M LISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 323-8515
Mailing address
17703 HICKS RD, BEDFORD, OH 44146-4332
(440) 525-0811
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0027013
OH
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APRN.CNP.0027013
OH
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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