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Organization
LIVING WELL SPINE CENTER, LLC
Active
Organization
LIVING WELL SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MCCOSKEY D.C. (CHIROPRACTOR)
(937) 878-1071
Entity
Organization
Contact information
Practice address
1145 CHANNINGWAY DR., FAIRBORN, OH 45324
(937) 878-1071
(937) 878-2616
Mailing address
1145 CHANNINGWAY DR., FAIRBORN, OH 45324
(937) 878-1071
(937) 878-2616
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1581
OH
111N00000X
Chiropractor
Primary
3455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210783
ANTHEM
OH
01
—
000000354540
ANTHEM
OH
Enumeration date
05/04/2007
Last updated
08/27/2007
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