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Individual

LOLA DENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
109 E WASHINGTON JACKSON RD STE B, EATON, OH 45320-9793
(937) 456-2155
(937) 456-2155
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3293

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10003214A
IN
363A00000X
Physician Assistant
Primary
50.006536
OH

Other

Enumeration date
06/27/2020
Last updated
05/13/2021
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