Individual
LISA CORINNE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1268 MAPLE AVE, ATWATER, OH 44201-9504
(330) 671-3612
Mailing address
1268 MAPLE AVE, ATWATER, OH 44201-9504
(330) 671-3612
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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