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Organization
PHYSICIAN MANAGEMENT SERVICES OF SOUTHEAST OHIO, LLC
Active
Organization
PHYSICIAN MANAGEMENT SERVICES OF SOUTHEAST OHIO, LLC
Active
Parent organization
VAXCARE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
VAXCARE CORPORATION
Authorized official
BRETT KENEFICK (PRESIDENT)
(888) 829-8550
Entity
Organization
Contact information
Practice address
300 BUSINESS PKWY, CARLISLE, OH 45005-6331
(888) 829-8550
Mailing address
3113 LAWTON RD STE 250, ORLANDO, FL 32803-3517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
04/27/2022
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