Individual
MS. ANITRA D STURDIVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 MOLANE ST, DAYTON, OH 45416-1825
(937) 371-2976
Mailing address
4240 MOLANE ST, DAYTON, OH 45416-1825
(937) 371-2976
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5716701
—
OH
Enumeration date
01/21/2021
Last updated
01/21/2021
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