Individual
DALE DEAN HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 TWIN RD, WEST ALEXANDRIA, OH 45381-7333
(937) 654-5993
Mailing address
1501 TWIN RD, WEST ALEXANDRIA, OH 45381-7333
(937) 654-5993
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RS541040
OH
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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