Individual
FALLON VIVIAN FLOYD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4150 SPRUCE PINE CT, DAYTON, OH 45424-4653
(937) 397-2569
Mailing address
4150 SPRUCE PINE CT, DAYTON, OH 45424-4653
(937) 397-2569
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
142792
OH
Other
Enumeration date
08/18/2011
Last updated
12/04/2016
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