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General NPI Number Information
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NPI Number | 1356935209
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Entity Type | Individual
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Provider Name | STACEY LYNN ZWIEBEL RPH
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Gender | Female
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 3994 E HARBOR RD
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City | PORT CLINTON
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State | OH
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Zip | 43452-2671
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Country | US
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Telephone | 419-732-6300
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Fax | 419-734-4063
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Provider Business Mailing Address
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Address Line | 8810 CEDAR POINT RD
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City | OREGON
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State | OH
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Zip | 43616-5888
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Country | US
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Telephone | 419-260-9544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-22793
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License Number State | OH
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