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General NPI Number Information
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NPI Number | 1053508077
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Entity Type | Organization
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Legal Business Name | JOURNEY LITE OF CINCINNATI, LLC
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 10475 READING ROAD SUITE 115
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City | CINCINNATI
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State | OH
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Zip | 45241
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Country | US
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Telephone | 513-259-2488
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Fax | 513-259-2487
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Provider Business Mailing Address
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Address Line | 10475 READING ROAD SUITE 115
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City | CINCINNATI
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State | OH
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Zip | 45241
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Country | US
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Telephone | 513-259-2488
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Fax | 704-341-8826
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LISA SPRONG
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Credential |
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Telephone | 513-399-5736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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