Individual
MR. BRYAN V LICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
17080 SAFETY ST STE 109, FORT MYERS, FL 33908-7506
(888) 499-5672
(888) 501-0844
Mailing address
17080 SAFETY ST STE 109, FORT MYERS, FL 33908-7506
(888) 499-5672
(888) 501-0844
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
169
GA
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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