| NPI | 1912310400 |
|---|---|
| Doing Business As | MEDICAL SOUTH FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | KENNETH PRUNIER CEO/President 937-499-8205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |