Provider Demographics
NPI:1811737570
Name:BLYTHE, TERRIONA NECCO
Entity type:Individual
Prefix:MISS
First Name:TERRIONA
Middle Name:NECCO
Last Name:BLYTHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4262
Mailing Address - Country:US
Mailing Address - Phone:937-463-3110
Mailing Address - Fax:
Practice Address - Street 1:3531 CORNELL DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-4262
Practice Address - Country:US
Practice Address - Phone:937-463-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle