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General NPI Number Information
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NPI Number | 1366045080
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Entity Type | Individual
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Provider Name | LISA MICHELLE FELDMANN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 710 N MAIN ST
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City | SPRINGBORO
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State | OH
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Zip | 45066-8944
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Country | US
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Telephone | 937-748-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 6474 KATHERINE MANOR CT
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City | LIBERTY TWP
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State | OH
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Zip | 45011-9232
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Country | US
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Telephone | 513-755-3828
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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 | 03120421
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License Number State | OH
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