Michele Ericson

NPI #1679749394 in Lisbon, Ohio

Provider Information

NPI Number: 1679749394
Entity Type: Individual
Name: Michele Ericson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: May 2, 2008
Last Updated: Sep 17, 2008

Practice Location

Address: 6102 LOW RD
City: Lisbon
State: Ohio
ZIP Code: 44432-9347
Phone: (330) 301-4595

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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