Individual
AUSTI DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4950 NORTHCUTT PL, DAYTON, OH 45414-3840
(937) 496-2020
Mailing address
6357 NIGHTWIND CT, DAYTON, OH 45424-1358
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.140117-M-IV
OH
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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