Individual
CASEY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-4478
Mailing address
1511 OJIBWAS CT, GROVE CITY, OH 43123-9594
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03438676
OH
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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