Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Parent organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Other names
Licking Memorial Dermatology Pataskala
Organization subpart
Yes
Provider details
NPI number
Legal business name
LICKING MEMORIAL PROFESSIONAL CORPORATION
Authorized official
CYNTHIA L. WEBSTER (VP FINANCIAL SERVICES)
(740) 348-4518
Entity
Organization
Contact information
Practice address
1 HEALTHY PL, SUITE 205, PATASKALA, OH 43062-7067
(740) 348-1930
(740) 348-1931
Mailing address
1 HEALTHY PL, SUITE 205, PATASKALA, OH 43062-7067
(740) 348-1930
(740) 348-1931
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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