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Individual

ANGELA LONG PRENTICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9000 N MAIN ST, STE 202, ENGLEWOOD, OH 45415-1165
(937) 832-9700
(937) 832-8663
Mailing address
9000 N MAIN ST, STE 202, ENGLEWOOD, OH 45415-1165
(937) 832-9700
(937) 832-8663

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.063987
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0984403
OH
Enumeration date
06/07/2006
Last updated
05/03/2017
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