Individual
DUSTIN KYLE BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
530 2ND AVE, GALLIPOLIS, OH 45631
(740) 446-2085
(740) 446-2292
Mailing address
214 S 4TH ST, IRONTON, OH 45638-1610
(740) 532-3767
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
167975
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/10/2018
Last updated
08/28/2018
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