Individual
MR. CORRY BENSON HAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6122 FIRESIDE DR, APT B, CENTERVILLE, OH 45459-2035
(937) 723-7503
Mailing address
6122 FIRESIDE DR, APT B, CENTERVILLE, OH 45459-2035
(937) 723-7503
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA00518
OH
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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