Healthcare Provider Details

I. General information

NPI: 1932152469
Provider Name (Legal Business Name): MVHE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 E STEWART ST
DAYTON OH
45409-2624
US

IV. Provider business mailing address

51 E STEWART ST
DAYTON OH
45409-2624
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-7070
  • Fax: 937-208-7060
Mailing address:
  • Phone: 937-208-7070
  • Fax: 937-208-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH PRUNIER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 937-208-8213