Individual
LISA LYNN RIEBE-MICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14952 MERMILL RD, RUDOLPH, OH 43462-9624
(419) 277-4058
Mailing address
14952 MERMILL RD, RUDOLPH, OH 43462-9624
(419) 277-4058
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
376J00000X
OH
Other
Enumeration date
12/20/2020
Last updated
12/20/2020
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