Individual
MARA PRICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3200
Mailing address
405 W GRAND AVE, DAYTON, OH 45405-7538
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005179RX
OH
Other
Enumeration date
08/09/2017
Last updated
04/26/2021
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