Individual
MARK ROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6429 KINGS GRANT PSGE, DAYTON, OH 45459-2959
(937) 293-0261
Mailing address
6429 KINGS GRANT PSGE, DAYTON, OH 45459-2959
(937) 293-0261
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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