Individual
GARY LEE RISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
77 EATON ST, DELAWARE, OH 43015-2515
(740) 971-7444
Mailing address
77 EATON ST, DELAWARE, OH 43015-2515
(740) 971-7444
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.150699-M-IV
OH
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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