Individual
DANIEL HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6911 BRECKENWOOD DR, DAYTON, OH 45424-7326
(937) 408-6969
Mailing address
6911 BRECKENWOOD DR, DAYTON, OH 45424-7326
(937) 408-6969
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419411
—
OH
Enumeration date
11/13/2020
Last updated
11/13/2020
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