Individual
DR. BRENDA LOUISE BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
850 W EMMITT AVE, SUITE 5, WAVERLY, OH 45690-1092
(740) 941-1902
(740) 941-1913
Mailing address
850 W EMMITT AVE, SUITE 5, WAVERLY, OH 45690-1092
(740) 941-1902
(740) 941-1913
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35079787B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2278646
—
OH
Enumeration date
05/23/2007
Last updated
07/08/2007
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