Organization
DAYTON CHILDREN'S ORTHOPAEDIC CENTER FOR SPINAL & PEDIATRIC CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA COFFEY (PRESIDENT)
(937) 641-3610
Entity
Organization
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404
(937) 641-3010
(937) 641-5003
Mailing address
1 CHILDRENS PLZ, DAYTON, OH 45404-1898
(937) 641-3010
(937) 641-5003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
050826
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060237
—
OH
05
—
200251960A
—
IN
01
—
2125835800
BUREAU OF WORKERS COMP
OH
05
—
2155448
—
OH
01
—
2252233
AETNA
OH
01
—
65901415
KENTUCKY PASSPORT
KY
05
—
65901415
—
KY
05
—
914700400
—
FL
01
—
CG2790
PARAMOUNT
OH
Enumeration date
05/23/2005
Last updated
06/19/2018
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