Organization
KETTERING INTEGRATED SERVICES LLC
Active
Other names
Renew Boutique and Spa
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KO (KETTERING HEALTH CFO)
(937) 558-3223
Entity
Organization
Contact information
Practice address
3700 SOUTHERN BLVD, KETTERING, OH 45429-1226
(937) 281-3855
Mailing address
2110 LEITER RD, MIAMISBURG, OH 45342-3598
(937) 914-7601
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0234746
—
OH
Enumeration date
12/15/2016
Last updated
08/02/2024
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