Individual
VICKI SUE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 W WENGER RD, ENGLEWOOD, OH 45322-2754
(937) 832-4343
(937) 832-4363
Mailing address
12 W WENGER RD, ENGLEWOOD, OH 45322-2754
(937) 832-4343
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173220
—
OH
Enumeration date
03/19/2021
Last updated
03/19/2021
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