Individual
KAITLIN RAELEEN LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
405 B WASHINGTON JACKSON ROAD, SUITE 108, EATON, OH 45320
(937) 456-8330
Mailing address
6845 CASTLEROCK TRL APT C, DAYTON, OH 45459-6024
(937) 239-7818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
50.007778RX
OH
363A00000X
Physician Assistant
Primary
50.007778RX
OH
Other
Enumeration date
09/30/2022
Last updated
04/19/2023
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