Organization
ESTHETIC DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT D. QUAKENBUSH CCP (OWNER)
(937) 429-8500
Entity
Organization
Contact information
Practice address
4049 DAYTON-XENIA RD., BEAVERCREEK, OH 45432-1992
(937) 429-8500
Mailing address
4049 DAYTON-XENIA RD., BEAVERCREEK, OH 45432-1992
(937) 429-8500
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
OH
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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