Individual
ELIZABETH TKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 MYSTIC LN, TROY, OH 45373-2254
(937) 332-3860
Mailing address
2560 RENWICK WAY, TROY, OH 45373-8461
(937) 440-9553
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.110148
OH
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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