Individual
LISA MARTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
410 PROVIDENCE DR, MEDINA, OH 44256-4327
(330) 990-7543
Mailing address
410 PROVIDENCE DR, MEDINA, OH 44256-4327
(330) 990-7543
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
—
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
06/30/2018
Last updated
05/31/2023
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