Individual
MS. MARYELLEN L EICKMAN-FIALA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 354-1990
(440) 350-4514
Mailing address
PO BOX 714031, COLUMBUS, OH 43271-4031
(440) 716-1283
(440) 716-1605
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD1264
OH
Other
Enumeration date
04/11/2006
Last updated
07/08/2007
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