Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 33 018370 | OH |
NPI | 1205197027 |
---|---|
Provider Name | Ms. Phyllis Sue George |
First Address | Lima, OH 45801 |
Second Address | Lima, OH 45801-2411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 07/06/2012 |