Individual
JENNIFER ALISSA NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8646
(937) 395-8697
Mailing address
2110 LEITER RD, MIAMISBURG, OH 45342-3660
(937) 384-4841
(937) 522-7626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50003466
OH
Other
Enumeration date
03/06/2012
Last updated
03/20/2012
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