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Organization

LIFESTYLE HEALTH CARE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT RANDAL BRUCE D.C. (PRESIDENT)
(419) 394-8194
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1393
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0868744
OH
Enumeration date
02/21/2008
Last updated
02/21/2008
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