Organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Active
Parent organization
LICKING MEMORIAL PROFESSIONAL CORPORATION
Other names
Licking Memorial Rheumatology
Organization subpart
Yes
Provider details
NPI number
Legal business name
LICKING MEMORIAL PROFESSIONAL CORPORATION
Authorized official
CYNTHIA L. WEBSTER (VP FINANCIAL SERVICE)
(740) 348-4518
Entity
Organization
Contact information
Practice address
1272 WEST MAIN STREET BLDG 2, STE 4, NEWARK, OH 43055
(740) 348-7975
(740) 348-7976
Mailing address
1272 WEST MAIN STREET BLDG 2, STE 4, NEWARK, OH 43055
(740) 348-7975
(740) 348-7976
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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