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1053970509
LARA HOUSEHOLDER
ATHENS, OH
NPI
1053970509
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: OH 34.016620)
Enumeration Date
2019-06-09
Last Update Date
2023-09-06
Business Address
LARA HOUSEHOLDER
26 E PARK DR STE 105C
ATHENS, OH 45701-5003
Phone number: 740-423-4015
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Mailing Address
LARA HOUSEHOLDER
149 NORTH ST
WATERVILLE, ME 04901-4974
Phone number: 207-861-5101
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