Provider Demographics
NPI:1649978172
Name:BETSINGER, BRYON RICHARD
Entity type:Individual
Prefix:MR
First Name:BRYON
Middle Name:RICHARD
Last Name:BETSINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 HILDRETH DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-1818
Mailing Address - Country:US
Mailing Address - Phone:937-974-3028
Mailing Address - Fax:
Practice Address - Street 1:1822 HILDRETH DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-1818
Practice Address - Country:US
Practice Address - Phone:937-974-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRP268752172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver