Individual
KAVICO WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1507 SHELLEY DR, DAYTON, OH 45406-4243
(937) 321-1237
Mailing address
1507 SHELLEY DR, DAYTON, OH 45406-4243
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
TB020592
OH
347C00000X
Private Vehicle
TB020592
OH
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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