Healthcare Provider Details

I. General information

NPI: 1558484709
Provider Name (Legal Business Name): J W DEVERS & SON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 N BROADWAY ST
TROTWOOD OH
45426-3501
US

IV. Provider business mailing address

5 N BROADWAY ST
TROTWOOD OH
45426-3501
US

V. Phone/Fax

Practice location:
  • Phone: 937-854-3040
  • Fax:
Mailing address:
  • Phone: 937-854-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE WOLF
Title or Position: VP
Credential:
Phone: 937-854-3040