Individual
MR. ALLAN DALLAS PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1608 TEXAS CT, XENIA, OH 45385-4864
(937) 372-5327
Mailing address
1608 TEXAS CT, XENIA, OH 45385-4864
(937) 372-5327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN113154
OH
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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