MARY ELAINE FORTKAMP

DAYTON, OH
NPI1427298793
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy246ZS0410X Specialist/Technologist, Other, Surgical Technologist
(Licence: OH  027735)
Enumeration Date2009-02-26
Last Update Date2009-02-26
Business Address
-- MARY ELAINE FORTKAMP CST
1520 S MAIN ST
DAYTON, OH 45409-2698
Phone number: 937-223-1279
Mailing Address
-- MARY ELAINE FORTKAMP CST
7584 ROSELAKE DR
DAYTON, OH 45414-2251
Phone number: 937-454-5247
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