| NPI | 1720161086 |
|---|---|
| Doing Business As | FAMILY MEDICINE OF VANDALIA |
| Entity Type | Organization |
| Authorized Contact | KENNETH PRUNIER CEO/Presiden 937-208-8273 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2013-11-08 |