Individual
GREGORY DAVID STOCKDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 WAYNE AVE, DAYTON, OH 45410-1122
(937) 496-2000
Mailing address
553 HATHAWAY TRL, TIPP CITY, OH 45371-1154
(937) 308-3807
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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