Individual
CHARNESE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2413 ULRICH AVE, DAYTON, OH 45406-2620
(937) 204-7159
Mailing address
2413 ULRICH AVE, DAYTON, OH 45406-2620
(937) 204-7159
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
RQ768429
OH
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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