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General NPI Number Information
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NPI Number | 1407325939
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Entity Type | Organization
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Legal Business Name | LSWHB LLC
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 675 HOBBY HORSE LN
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City | MILFORD
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State | OH
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Zip | 45150-1461
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Country | US
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Telephone | 513-443-1700
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Fax | 855-919-6229
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Provider Business Mailing Address
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Address Line | 675 HOBBY HORSE LN
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City | MILFORD
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State | OH
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Zip | 45150-1461
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Country | US
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Telephone | 513-443-1700
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Fax | 855-919-6229
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Authorized Official
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Title or Position | PRESIDENT
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Name | NEWELL DEL CRANE
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Credential | PHD
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Telephone | 513-404-9932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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