Individual
ARTHUR MARK LICONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
180 EARL DR, ERIE, PA 16509-5504
(814) 217-9688
Mailing address
180 EARL DR, ERIE, PA 16509-5504
(814) 217-9688
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN279884
PA
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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