Healthcare Provider Details

I. General information

NPI: 1417190927
Provider Name (Legal Business Name): MRS. TERESA R. KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5450 FAR HILLS AVE
KETTERING OH
45429-2386
US

IV. Provider business mailing address

5450 FAR HILLS AVE
KETTERING OH
45429-2386
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-2920
  • Fax: 937-435-2190
Mailing address:
  • Phone: 937-435-2920
  • Fax: 937-435-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: