Individual
EVELYN FABIOLA LISIECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PN140320MIV
Contact information
Practice address
1024 COLONIAL AVE, MARION, OH 43302-6925
(740) 223-3414
Mailing address
1024 COLONIAL AVE, MARION, OH 43302-6925
(740) 223-3414
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN140320MIV
OH
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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