| NPI | 1740472604 |
|---|---|
| Doing Business As | LICKING MEMORIAL DERMATOLOGY NORTH NEWARK |
| Entity Type | Organization |
| Authorized Contact | RENEE SPRING-IVES Credentialing Coordnator 740-348-4027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |