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Individual

AUSTIN BISHOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4271 GLENWAY AVE, DEER PARK, OH 45236-3631
(513) 310-9191
Mailing address
4271 GLENWAY AVE, DEER PARK, OH 45236-3631
(513) 310-9191

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0402261
OH
Enumeration date
06/09/2020
Last updated
06/09/2020
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