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Individual

LISA J FOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
820 PINEHURST ST, MARYSVILLE, OH 43040-1336
(937) 893-2121
Mailing address
820 PINEHURST ST, MARYSVILLE, OH 43040-1336
(937) 893-2121

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0234725
OH
Enumeration date
09/28/2020
Last updated
09/28/2020
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