Healthcare Provider Details

I. General information

NPI: 1205091717
Provider Name (Legal Business Name): MRS. LINDA PALMETTA SPICKARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 FRANKLIN ST
TORONTO OH
43964-1949
US

IV. Provider business mailing address

223 E ALEXANDER CT
WEIRTON WV
26062-5032
US

V. Phone/Fax

Practice location:
  • Phone: 740-537-9425
  • Fax: 740-537-9837
Mailing address:
  • Phone: 304-723-0573
  • Fax: 304-723-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-22897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: