Provider Demographics
NPI:1669655304
Name:WILLETT, DARRYL A (SA)
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:A
Last Name:WILLETT
Suffix:
Gender:M
Credentials:SA
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Mailing Address - Street 1:4701 CREEK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-8398
Mailing Address - Country:US
Mailing Address - Phone:513-618-9011
Mailing Address - Fax:513-588-2479
Practice Address - Street 1:7575 5 MILE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4346
Practice Address - Country:US
Practice Address - Phone:513-232-6677
Practice Address - Fax:513-232-2522
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2011-10-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist