Individual
DOUG KENNETH ANDRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 W GEISERMAN RD, PIQUA, OH 45356-8507
(193) 754-1127
(937) 778-0568
Mailing address
575 W GEISERMAN RD, PIQUA, OH 45356-8507
(193) 754-1127
(937) 778-0568
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171WH0202X
—
OH
Enumeration date
07/27/2022
Last updated
07/27/2022
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