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Individual

KRYSTINA BODALIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6939 COX RD STE 360, LIBERTY TOWNSHIP, OH 45069
(513) 564-6800
(513) 564-6815
Mailing address
6939 COX RD STE 360, LIBERTY TOWNSHIP, OH 45069-7595
(513) 564-6800
(513) 564-6815

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.134653
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0305000
OH
05
7100550300
KY
Enumeration date
06/09/2015
Last updated
10/30/2020
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