Individual
SUSAN K LICHTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 JENNINGS RD, VAN WERT, OH 45891-9784
(419) 605-3472
Mailing address
545 JENNINGS RD, VAN WERT, OH 45891-9784
(419) 605-3472
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
OH
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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