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Individual

GREGORY DALE BACK I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1275 E 2ND STREET, FRANKLIN, OH 45005
(937) 704-0809
(937) 704-0820
Mailing address
7518 WHITEHALL DR, DAYTON, OH 45459-3446
(347) 901-0406

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Enumeration date
02/17/2023
Last updated
02/17/2023
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