Individual
LORI ANN ZWICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6661 CLYO RD, CENTERVILLE, OH 45459-2767
(937) 425-4000
(937) 425-4002
Mailing address
6661 CLYO RD, CENTERVILLE, OH 45459-2767
(937) 425-4000
(937) 425-4002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50003379
OH
363AM0700X
Medical Physician Assistant
Primary
50.003379
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075601
—
OH
01
—
50003379
OHIO LICENSE
OH
Enumeration date
08/31/2011
Last updated
11/12/2020
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