Individual
ABIGAIL TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-8000
Mailing address
4028 N STATE ROUTE 134, WILMINGTON, OH 45177-9608
(937) 725-5212
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.009325RX
OH
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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