# LIFESTYLE HEALTH CARE CENTER

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

## Provider details

- **NPI number:** 1801065107
- **Authorized official:** SCOTT RANDAL BRUCE D.C. (PRESIDENT)
- **Authorized official phone:** (419) 394-8194

## Contact information

- **Practice address:** 1633 CELINA RD, ST. MARYS, OH 45885-1812
- **Practice address phone:** (419) 394-8194
- **Mailing address:** PO BOX 308, ST. MARYS, OH 45885-0308
- **Mailing address phone:** (419) 394-8194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1393 | OH | Yes |

## Other

- **Enumeration date:** 02/21/2008
- **Last updated:** 02/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0868744 | — | OH |