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1619302791
GWENDOLYN IRENE THACKER
MIAMISBURG, OH
NPI
1619302791
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: OH COA.14947-NP)
Enumeration Date
2013-09-09
Last Update Date
2020-11-17
Business Address
GWENDOLYN IRENE THACKER CNP
4000 MIAMISBURG CENTERVILLE RD SUITE 110
MIAMISBURG, OH 45342-7615
Phone number: 937-865-9000
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Mailing Address
GWENDOLYN IRENE THACKER CNP
4000 MIAMISBURG CENTERVILLE RD STE 110
MIAMISBURG, OH 45342-3674
Phone number: 937-865-9000
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