Individual
EMILY GRACE TROMPAK (O'NEAL)
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3535 PENTAGON BLVD, BEAVERCREEK, OH 45431-1705
(937) 702-4450
(937) 702-4459
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3666
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3666
TENNESSEE LICENSE
TN
Enumeration date
09/14/2016
Last updated
01/11/2022
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