| NPI | 1396974556 |
|---|---|
| Doing Business As | BREIEL BLVD FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KENNETH PRUNIER President/CEO 937-208-8213 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2010-10-12 |