Lori Mcnickle, CPED, RFOM

NPI #1861733396 in Canton, Ohio

Provider Information

NPI Number: 1861733396
Entity Type: Individual
Name: Lori Mcnickle, CPED, RFOM
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pedorthist
Credential: CPED, RFOM
Enumeration Date: Mar 7, 2013
Last Updated: Mar 7, 2013

Practice Location

Address: 4663 WHIPPLE AVE NW
City: Canton
State: Ohio
ZIP Code: 44718-2615
Phone: (330) 479-0020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pedorthist	224L00000X	Primary

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