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General NPI Number Information
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NPI Number | 1528359155
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Entity Type | Individual
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Provider Name | SUSAN KATHLEEN WERNER HUCK R.PH.
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Gender | Female
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Dates
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Enumeration Date | 04/30/2011
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Last Update Date | 04/30/2011
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Provider Practice Location Address
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Address Line | 1158 WILMINGTON AVE
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City | DAYTON
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State | OH
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Zip | 45420-1662
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Country | US
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Telephone | 937-252-9894
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Fax | 937-256-8062
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Provider Business Mailing Address
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Address Line | 2900 MEADOW PARK DR
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City | KETTERING
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State | OH
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Zip | 45440-1421
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Country | US
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Telephone | 937-296-1435
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Fax | 937-296-1435
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03314376
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License Number State | OH
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