Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 35-08-8584 | OH |
NPI | 1073688776 |
---|---|
Provider Name | Lisa Richer Ford |
First Address | Canton, OH 44710 |
Second Address | Canton, OH 44710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 04/11/2010 |