Individual
DALE ANTHONY KIRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 ANDERSON STATE ROAD, FAYETTEVILLE, OH 45118
(937) 205-2337
(513) 875-2811
Mailing address
PO BOX 141, FAYETTEVILLE, OH 45118-0141
(937) 205-2337
(513) 875-2811
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
2291023
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2291023
—
OH
Enumeration date
10/10/2006
Last updated
07/09/2007
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