Individual
MISS SCARLETT J CTVRTNICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4100 W 3RD ST, #112, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
4100 W 3RD ST, #112, DAYTON, OH 45428-9000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA052105
PA
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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