Individual
BROOKE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
8800 KINGSRIDGE DR, DAYTON, OH 45458-1616
(937) 436-3472
Mailing address
406 DUNDEE CIR, DAYTON, OH 45431-2118
(937) 344-5959
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
OH
Other
Enumeration date
02/15/2023
Last updated
02/15/2023
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