Individual
GINA MICCINILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44 GREENFIELD ST, TIFFIN, OH 44883-2445
(740) 816-6762
Mailing address
44 GREENFIELD STREET, TIFFIN, OH 44883
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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