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Individual

ELIZABETH NEWCOMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
981 NEIL CIR N, MANSFIELD, OH 44903-7699
(567) 215-3675
Mailing address
1801 GASCHE ST APT C15, WOOSTER, OH 44691-2494
(567) 215-3675

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
0201508
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0201508
OH
Enumeration date
06/24/2022
Last updated
06/24/2022
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