Healthcare Provider Details

I. General information

NPI: 1134825698
Provider Name (Legal Business Name): DONALD FRANCIS LYTLE CPRS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14297 STATE ROUTE 41
WEST UNION OH
45693-3700
US

IV. Provider business mailing address

413 W 2ND ST UNIT A
MANCHESTER OH
45144-1040
US

V. Phone/Fax

Practice location:
  • Phone: 513-409-3635
  • Fax:
Mailing address:
  • Phone: 937-712-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: