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Individual

DOUGLAS GLEASON DANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
774 ALPHA RD, ALPHA, OH 45301-8009
(937) 429-1989
Mailing address
PO BOX 45, ALPHA, OH 45301-0045
(937) 429-1989

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary

Other

Enumeration date
10/13/2020
Last updated
10/13/2020
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