Organization
LICKING MEMORIAL PROFESSIONAL CORP.
Active
Other names
Licking Memorial Physician Wound Services
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L. WEBSTER (VP FINANCIAL SERVICE)
(740) 348-4518
Entity
Organization
Contact information
Practice address
2000 TAMARACK RD, NEWARK, OH 43055
(740) 348-1993
(740) 348-1994
Mailing address
2000 TAMARACK RD, NEWARK, OH 43055
(740) 348-1993
(740) 348-1994
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
02/18/2013
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