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NPI Code Detail

MEDICARE: JOHN FRISCO LISW

MEDICARE: JOHN FRISCO LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerI-0000891OH

General Provider Information

NPI Number : 1962517268
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN FRISCO LISW
Provider Business Mailing Address
First Line : 493 MILLBROOK ST
Second Line :
City : CANFIELD
State : OH
Zip : 44406-9663
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 40722 STATE ROUTE 154
Second Line :
City : LISBON
State : OH
Zip : 44432-8500
Country : US
Telephone Number : 330-424-9573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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