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1275177917
SHANNON DOHERTY
DAYTON, OH
NPI
1275177917
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OH 164178)
Enumeration Date
2019-11-06
Last Update Date
2019-11-06
Business Address
SHANNON DOHERTY
600 WAYNE AVE
DAYTON, OH 45410-1122
Phone number: 937-496-2000
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Mailing Address
SHANNON DOHERTY
600 WAYNE AVE
DAYTON, OH 45410-1122
Phone number:
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