Individual
MR. NICKOLAS PAUL BURICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 OHIO ST, LODI, OH 44254-1048
(330) 691-9187
Mailing address
116 OHIO ST, LODI, OH 44254-1048
(330) 691-9187
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
372600000X
Adult Companion
3726000000X
OH
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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