Individual
MRS. LISA NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 WAGGONER RD, REYNOLDSBURG, OH 43068-9707
(614) 501-5600
Mailing address
3790 FOREST GREEN BLVD NW, BALTIMORE, OH 43105-9553
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
273526
OH
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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