Individual
SANDRA D. GREENFEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 E FRONT ST, MANCHESTER, OH 45144-1554
(937) 549-2416
Mailing address
619 E FRONT ST, MANCHESTER, OH 45144-1554
(937) 549-2416
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2624002
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2624002
—
OH
Enumeration date
03/15/2007
Last updated
07/09/2007
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