Individual
CRYSTAL L FOTHERINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
326 W COLUMBIA ST, ALLIANCE, OH 44601-2330
(330) 244-6288
Mailing address
326 W COLUMBIA ST, ALLIANCE, OH 44601-2330
(330) 244-6288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
137900
OH
Other
Enumeration date
04/13/2010
Last updated
07/08/2010
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