Individual
MELISSA RENEE FETTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4305 OLD TROY PIKE, DAYTON, OH 45404-1331
(937) 520-5577
Mailing address
4305 OLD TROY PIKE, DAYTON, OH 45404-1331
(937) 520-5577
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OH
Other
Enumeration date
12/16/2020
Last updated
12/21/2020
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