Individual
MINDY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 HALE ST, WILMINGTON, OH 45177-2104
(937) 382-1621
Mailing address
942 BALSAM WOOD LN, LEBANON, OH 45036-8528
(937) 763-5585
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA08438
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA08438
OTPTAT
OH
Enumeration date
02/03/2015
Last updated
03/08/2024
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