Individual
KELLY BASLER FLUECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4824 LAUREL AVE, BLUE ASH, OH 45242-7036
(513) 205-6983
Mailing address
4824 LAUREL AVE, BLUE ASH, OH 45242-7036
(513) 205-6983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SC82885
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105397307799
—
OH
Enumeration date
01/23/2007
Last updated
10/21/2020
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