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Individual

LORI A FANNIN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
315 N MARKET ST, GALION, OH 44833-1923
(419) 468-6222
(419) 468-8259
Mailing address
315 N MARKET ST, GALION, OH 44833-1923
(419) 468-6222
(419) 468-8259

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
36002701
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0829198
OH
Enumeration date
01/10/2006
Last updated
07/08/2007
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