Individual
MS. LISA M GROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
122 WYOMING ST, DAYTON, OH 45409-2731
(937) 264-3037
Mailing address
122 WYOMING ST, DAYTON, OH 45409-2731
(937) 264-3037
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001238
OH
Other
Enumeration date
10/10/2006
Last updated
04/09/2008
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