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810 Falls Creek Dr Suite B Vandalia OH 45377-8600 | |
(937) 454-0317 | |
(937) 454-1668 |
Full Name | |
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Speciality | Family Medicine |
Location | 810 Falls Creek Dr, Vandalia, Ohio |
Authorized Official Name and Position | Kenneth Prunier (CEO/PRESIDEN) |
Authorized Official Contact | 9372088273 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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810 Falls Creek Dr Suite B Vandalia OH 45377-8600 Ph: (937) 454-0317 | 810 Falls Creek Dr Suite B Vandalia OH 45377-8600 Ph: (937) 454-0317 |
NPI Number | 1720161086 |
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Provider Enumeration Date | 10/23/2006 |
Last Update Date | 11/08/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720161086 | NPI | - | NPPES |
2552134 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Hocks Wellness Consulting Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 535 S Dixie Dr, Vandalia, OH 45377 Phone: 937-889-2121 Fax: 937-898-9340 | |
North Dayton Addiction & Recovery, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S Dixie Drive, Suite 4, Vandalia, OH 45377 Phone: 937-416-5442 | |