Provider Demographics
NPI:1609206390
Name:LIVING WELL OHIO
Entity Type:Organization
Organization Name:LIVING WELL OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-410-8545
Mailing Address - Street 1:10615 MONTGOMERY RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4460
Mailing Address - Country:US
Mailing Address - Phone:513-984-9355
Mailing Address - Fax:513-475-3580
Practice Address - Street 1:771 CORPORATE DR STE 610
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5440
Practice Address - Country:US
Practice Address - Phone:859-410-8550
Practice Address - Fax:859-223-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty