Individual
MARY KATELIN KANOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4441 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 298-7351
(937) 298-9458
Mailing address
4441 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 298-7351
(937) 298-9458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35121178
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084532
—
OH
Enumeration date
05/17/2010
Last updated
01/20/2021
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