Provider Demographics
NPI:1104012418
Name:MKDF ENTERPRISE
Entity Type:Organization
Organization Name:MKDF ENTERPRISE
Other - Org Name:HEALTHWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PREDIDENT / BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:STRADLEY
Authorized Official - Last Name:FLICKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-751-1288
Mailing Address - Street 1:2200 VICTORY PKWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2882
Mailing Address - Country:US
Mailing Address - Phone:513-751-1288
Mailing Address - Fax:513-751-7597
Practice Address - Street 1:2200 VICTORY PKWY
Practice Address - Street 2:SUITE 600
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2882
Practice Address - Country:US
Practice Address - Phone:513-751-1288
Practice Address - Fax:513-751-7597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare