Individual
STANLEY LAMAR PEAVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11065 GRAND AVE, BLUE ASH, OH 45242-2927
(513) 386-7801
Mailing address
11065 GRAND AVE, BLUE ASH, OH 45242-2927
(513) 386-7801
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
03/09/2013
Last updated
03/09/2013
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