Healthcare Provider Details

I. General information

NPI: 1023392560
Provider Name (Legal Business Name): MEGAN E BETTS CST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 N MAIN ST. STE 303
DAYTON OH
45415
US

IV. Provider business mailing address

9000 N MAIN ST. STE 303
DAYTON OH
45415
US

V. Phone/Fax

Practice location:
  • Phone: 937-836-3118
  • Fax: 937-832-5588
Mailing address:
  • Phone: 937-836-3118
  • Fax: 937-832-5588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberNO LICENSE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: