Individual
WYNNSLO LYDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1329 COUNTY LINE RD, CRESTLINE, OH 44827-4482
(419) 571-6151
Mailing address
1329 COUNTY LINE RD, CRESTLINE, OH 44827-1217
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC-04746
OH
Other
Enumeration date
08/16/2017
Last updated
09/13/2020
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