Healthcare Provider Details

I. General information

NPI: 1659357770
Provider Name (Legal Business Name): EMMA E GARCIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 REMICK BLVD
SPRINGBORO OH
45066-9168
US

IV. Provider business mailing address

2912 SPRINGBORO W SUITE 201
DAYTON OH
45439-1674
US

V. Phone/Fax

Practice location:
  • Phone: 937-885-0701
  • Fax: 937-885-0702
Mailing address:
  • Phone: 937-297-8996
  • Fax: 937-885-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34004456
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: