NPI 1023605862

Shana Lynette Mundy

Practitioner Preferred Provider Organization Springfield, OH

Practice location

Address: 345 Larchmont Ave, Springfield, OH 45503-5423
Phone: (937) 631-5017

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1023605862
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Dec 2020
Record last updated: 28 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.