Individual
MS. THERESA LYNN VACHERESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2525 TILLER LN, SUITE 105, COLUMBUS, OH 43231-2267
(614) 901-0000
(614) 901-4117
Mailing address
855 W COSHOCTON ST, JOHNSTOWN, OH 43031-9587
(614) 901-0000
(614) 901-4117
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36003295
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2305991
—
OH
Enumeration date
06/20/2005
Last updated
12/29/2011
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