Individual
MRS. IMOGENE C. PEAVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
849 N EUCLID AVE, DAYTON, OH 45402-5909
(937) 278-2870
(937) 278-2870
Mailing address
849 N EUCLID AVE, DAYTON, OH 45402-5909
(937) 278-2870
(937) 278-2870
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-082172
OH
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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