# FAIRFIELD SPINE CENTER,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083793830
- **Authorized official:** DR. JAMES R GRILLIOT D.C. (PARTNER)
- **Authorized official phone:** (740) 687-5002

## Contact information

- **Practice address:** 1600 SHERIDAN DR, LANCASTER, OH 43130-1305
- **Practice address phone:** (740) 687-5002
- **Practice address fax:** (740) 687-5003
- **Mailing address:** 1600 SHERIDAN DR, LANCASTER, OH 43130-1305
- **Mailing address phone:** (740) 687-5002
- **Mailing address fax:** (740) 687-5003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | OH1555 | OH | — |
| 111N00000X | Chiropractor | OH940 | OH | Yes |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | OH0114683 | — | OH |
| 05 | — | OH0716498 | — | OH |