Individual
KIMBERLY HOPE FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3641 TEABERRY DR, DAYTON, OH 45424-5011
(937) 559-4107
Mailing address
3641 TEABERRY DR, DAYTON, OH 45424-5011
(937) 559-4107
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2447070
—
OH
Enumeration date
11/01/2006
Last updated
07/09/2007
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