Provider Demographics
NPI:1922765783
Name:MYO FAMILY HEALTH, LLC
Entity Type:Organization
Organization Name:MYO FAMILY HEALTH, LLC
Other - Org Name:MYO FAMILY HEALTH, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:RONDONI
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:707-631-1550
Mailing Address - Street 1:597 ROLLING OAK CT
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-1001
Mailing Address - Country:US
Mailing Address - Phone:707-631-1550
Mailing Address - Fax:
Practice Address - Street 1:490 CHADBOURNE RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9613
Practice Address - Country:US
Practice Address - Phone:707-631-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty