Individual
NICOLE BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDS
Contact information
Practice address
955 LIBERTY DR, LANCASTER, OH 43130-8045
(740) 653-3193
Mailing address
6763 ED LN, CANAL WINCHESTER, OH 43110-8210
(330) 473-0094
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OH3149295
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OH3149295
EDUCATOR STATE ID
OH
Enumeration date
10/10/2014
Last updated
10/10/2014
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