Individual
AUSTIN DENEFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2044 TOWNSHIP ROAD 57, BELLEFONTAINE, OH 43311-9551
(937) 407-4553
Mailing address
2044 TOWNSHIP ROAD 57, BELLEFONTAINE, OH 43311-9551
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
UA257265
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108138896799
—
OH
Enumeration date
07/12/2017
Last updated
07/12/2017
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