Organization
E G SYBRANDY-NICELY, DPM
Active
Other names
Lisa Nicely, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA G NICELY DPM (OWNER/PODIATRIST)
(937) 293-8448
Entity
Organization
Contact information
Practice address
1001 SHROYER RD, DAYTON, OH 45419-3635
(937) 293-8448
(937) 293-8448
Mailing address
1001 SHROYER RD, DAYTON, OH 45419-3635
(937) 293-8448
(937) 293-8448
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
36-002389
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0969831
—
OH
01
—
1235138496
NPI-INDIVIDUAL
OH
Enumeration date
02/15/2008
Last updated
02/15/2008
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