Organization
DVL VASCULAR LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON KAYE ROBERTS RVT (PRESIDENT)
(937) 220-9934
Entity
Organization
Contact information
Practice address
627 S EDWIN C MOSES BLVD, SUITE 3H, DAYTON, OH 45417-3461
(937) 220-9934
(937) 220-9936
Mailing address
PO BOX 276, ENGLEWOOD, OH 45322-0276
(937) 220-9934
(937) 220-9936
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
804704
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0872793
—
OH
Enumeration date
08/17/2005
Last updated
12/29/2011
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