Individual
LILIA A FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6927 GROVEBELLE DR, DAYTON, OH 45424-8115
(937) 760-2536
Mailing address
6927 GROVEBELLE DR, DAYTON, OH 45424-8115
(937) 236-0953
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103464506799
—
OH
Enumeration date
11/16/2020
Last updated
11/16/2020
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