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1083168454
JUSTIN STAFFORD
KETTERING, OH
NPI
1083168454
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OH 50.004770RX)
Enumeration Date
2016-08-15
Last Update Date
2020-11-19
Business Address
JUSTIN STAFFORD PA-C
3535 SOUTHERN BLVD
KETTERING, OH 45429-1221
Phone number: 937-395-6020
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Mailing Address
JUSTIN STAFFORD PA-C
3533 SOUTHERN BLVD SUITE 2100
KETTERING, OH 45429-1264
Phone number: 937-395-8556
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