Individual
KERRY KUNRONG NIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 E APPLE ST, STE 1480, DAYTON, OH 45409-2939
(937) 208-3220
(937) 208-3633
Mailing address
30 E APPLE ST, STE 1480, DAYTON, OH 45409-2939
(937) 208-3220
(937) 208-3633
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50002031
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110876
—
OH
Enumeration date
10/05/2006
Last updated
08/10/2015
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