| NPI | 1316115900 |
|---|---|
| Doing Business As | LISA NICELY, DPM |
| Entity Type | Organization |
| Authorized Contact | LISA G NICELY Owner/Podiatrist 937-293-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 36-002389) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |