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General NPI Number Information
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NPI Number | 1619517612
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Entity Type | Organization
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Legal Business Name | CITRAN OCCUPATIONAL HEALTH, LLC
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 7774 DAYTON SPRINGFIELD RD
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City | FAIRBORN
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State | OH
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Zip | 45324-1957
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Country | US
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Telephone | 937-340-6488
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Fax | 937-340-6512
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Provider Business Mailing Address
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Address Line | 7774 DAYTON SPRINGFIELD RD
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City | FAIRBORN
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State | OH
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Zip | 45324-1957
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Country | US
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Telephone | 937-340-6488
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Fax | 937-340-6512
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AMANDA INGOLD
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Credential | AT, ATC
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Telephone | 937-340-6488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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