Individual
MS. LISA L TYLICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
110 W HERRICK AVE, SUITE B, WELLINGTON, OH 44090-1240
(440) 647-0107
(440) 647-1030
Mailing address
148 MALLARD CREEK RUN, LAGRANGE, OH 44050-9804
(419) 447-7203
(419) 447-5577
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006703
OH
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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