Individual
GENA BERKSHIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E ALEX BELL RD STE 120, CENTERVILLE, OH 45459-2789
(937) 435-2437
(937) 435-9579
Mailing address
101 E ALEX BELL RD STE 120, CENTERVILLE, OH 45459-2789
(937) 435-2437
(937) 435-9579
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
S7395
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679987416
—
OH
Enumeration date
03/04/2015
Last updated
03/04/2015
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