Doctor Name: | LISA EDELBROCK RICKER |
NPI Number: | 1043544398 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | 33012163 |
Business Practice Address: | 913 W Logan St Celina, OH - 458222000 |
Business Phone Number: | 4195861333 |
Business Fax Number: | 4195861333 |
Mailing Address: | 913 W Logan St, CELINA |
State: | OH |
Postal Code: | 458222000 |
Phone Number: | 4195861333 |
Fax Number: | 4195861333 |
NPI Enumeration Date: | 09/18/2009 |
NPI Last Update Date: | 09/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 33012163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |