Organization
ENT CENTRAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYKOLA O PRYKHODKO M.D. (OWNER/PRESIDENT)
(419) 756-5500
Entity
Organization
Contact information
Practice address
770 BALGREEN DR, SUITE 209, MANSFIELD, OH 44906-4106
(419) 756-5500
(419) 756-5502
Mailing address
770 BALGREEN DR, SUITE 209, MANSFIELD, OH 44906-4106
(419) 756-5500
(419) 756-5502
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35.097400
OH
Other
Enumeration date
08/03/2011
Last updated
12/13/2011
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