| NPI | 1194999839 |
|---|---|
| Doing Business As | TYLERS PLACE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KENNETH PRUNIER CEO/President 937-208-8213 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |