Individual
BRIAN CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
369 W 1ST ST, DAYTON, OH 45402-3095
(937) 496-2620
Mailing address
3847 GARDENVIEW PL, KETTERING, OH 45429-4516
(937) 671-4315
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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