Organization
MVHE INC
Active
Other names
Medical South Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH PRUNIER (CEO/PRESIDENT)
(937) 499-8205
Entity
Organization
Contact information
Practice address
330 N MAIN ST, CENTERVILLE, OH 45459-4465
(937) 433-0960
(937) 433-0958
Mailing address
330 N MAIN ST, CENTERVILLE, OH 45459-4465
(937) 433-0960
(937) 433-0958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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