Provider Demographics
NPI:1649931353
Name:SIMPLY WELL, LLC
Entity type:Organization
Organization Name:SIMPLY WELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:SWARTZENDRUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-377-1624
Mailing Address - Street 1:415 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILROY
Mailing Address - State:IN
Mailing Address - Zip Code:46156-9747
Mailing Address - Country:US
Mailing Address - Phone:217-377-1624
Mailing Address - Fax:
Practice Address - Street 1:5721 DRAGON WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-4518
Practice Address - Country:US
Practice Address - Phone:513-271-1233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty