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Individual

MS. TRISHA L ENDICOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11999 STEUBENVILLE PIKE, LISBON, OH 44432-9707
(330) 424-4737
Mailing address
11999 STEUBENVILLE PIKE, LISBON, OH 44432-9707
(330) 424-4737

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
2104234
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107085842699
OH
05
171027384601
OH
Enumeration date
04/18/2007
Last updated
07/09/2007
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