Individual
DARLA C PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 KIMBERLY DR, KETTERING, OH 45429-4617
(937) 474-3066
Mailing address
4121 KIMBERLY DR, KETTERING, OH 45429-4617
(937) 474-3066
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
116723
OH
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3036557
—
OH
Enumeration date
11/16/2020
Last updated
11/16/2020
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