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General NPI Number Information
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NPI Number | 1861001190
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Entity Type | Organization
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Legal Business Name | SIMPLE HEALTH CLINIC LLC
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 10945 REED HARTMAN HWY STE 209
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City | BLUE ASH
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State | OH
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Zip | 45242-2853
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Country | US
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Telephone | 513-318-7783
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Fax |
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Provider Business Mailing Address
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Address Line | 10945 REED HARTMAN HWY STE 209
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City | BLUE ASH
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State | OH
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Zip | 45242-2853
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Country | US
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Telephone | 513-318-7783
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LIULI LI
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Credential |
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Telephone | 513-318-7783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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