| Dfas-jfll/in | |
|
4881 Sugar Maple Dr Dayton OH 45433-5529 | |
| (937) 257-9926 | |
| Not Available |
| Full Name | Dfas-jfll/in |
|---|---|
| Speciality | Clinic/center |
| Location | 4881 Sugar Maple Dr, Dayton, Ohio |
| Authorized Official Name and Position | Isaac Humphrey (SUPERVISOR) |
| Authorized Official Contact | 9372579926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfas-jfll/in 4881 Sugar Maple Dr Dayton OH 45433-5529 Ph: () - | Dfas-jfll/in 4881 Sugar Maple Dr Dayton OH 45433-5529 Ph: (937) 257-9926 |
| NPI Number | 1164892949 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164892949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 01073515A (Indiana) | Primary |
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