Organization
MVHE INC
Active
Parent organization
MVHE INC
Other names
South Town Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
MVHE INC
Authorized official
KENNETH PRUNIER (PRESIDENT/CEO)
(937) 208-8213
Entity
Organization
Contact information
Practice address
6611 CLYO RD, SUITE B, DAYTON, OH 45459-2786
(937) 208-7474
(937) 208-7470
Mailing address
6611 CLYO RD, SUITE B, DAYTON, OH 45459-2786
(937) 208-7474
(937) 208-7470
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2694188
—
OH
Enumeration date
10/26/2006
Last updated
11/06/2013
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