Organization
MEDTICARE TESTING CLINIC
Active
Organization
MEDTICARE TESTING CLINIC
Active
Other names
MedTiCare Testing Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TINASHIA SHANICE BRUNNER (CEO)
(513) 663-0607
Entity
Organization
Contact information
Practice address
3905 MACK RD, FAIRFIELD, OH 45014-7659
(513) 663-0607
Mailing address
3905 MACK RD APT 68, FAIRFIELD, OH 45014-6670
(513) 663-0607
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/11/2024
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