Most Relevant Information
Provider Data
| NPI Number: | 1003391392 |
| Provider Name: | LISA ANN REGAL |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LPN139337MEDSIV |
Most Important Dates
| Enumeration Date: | 10/02/2018 |
| Last Updated: | 10/02/2018 |
Provider Practice Location
200 E STATE ST FL 3
ALLIANCE
OH
446014936
Practice Location Phone/Fax
| Phone: | 3308218503 |
| Fax: | 3306270088 |
Provider Mailing Location
625 CLEVELAND AVE NW
CANTON
OH
447021805
Provider Mailing Phone/Fax
| Phone: | 3304550374 |
| Fax: | 3304536716 |