Provider Demographics
NPI:1982785838
Name:CINCINNATI WEIGHT LOSS CENTER, LLC
Entity Type:Organization
Organization Name:CINCINNATI WEIGHT LOSS CENTER, LLC
Other - Org Name:SYNCHRONY HEALTH, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-939-2263
Mailing Address - Street 1:9075 CENTRE POINTE DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4890
Mailing Address - Country:US
Mailing Address - Phone:513-939-2263
Mailing Address - Fax:513-874-4579
Practice Address - Street 1:9075 CENTRE POINTE DR
Practice Address - Street 2:SUITE 160
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4890
Practice Address - Country:US
Practice Address - Phone:513-939-2263
Practice Address - Fax:513-874-4579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty