Individual
SHAWN BRODESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
1138 S MAIN ST, WEST MILTON, OH 45383-1342
(937) 418-3301
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
381510
OH
163WG0000X
General Practice Registered Nurse
381510
OH
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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