Provider Demographics
NPI:1922089150
Name:NEAL, LISA RUTH (RPH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RUTH
Last Name:NEAL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 N GEYERS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44677-9744
Mailing Address - Country:US
Mailing Address - Phone:330-345-6435
Mailing Address - Fax:
Practice Address - Street 1:3540 BURBANK RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-8539
Practice Address - Country:US
Practice Address - Phone:330-345-5908
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-17508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist