Healthcare Provider Details

I. General information

NPI: 1134523947
Provider Name (Legal Business Name): DLBB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HORIZON DR STE 505
CHALFONT PA
18914-3962
US

IV. Provider business mailing address

121 HIGH ST
DUBLIN PA
18917-2313
US

V. Phone/Fax

Practice location:
  • Phone: 215-858-7867
  • Fax: 267-873-5787
Mailing address:
  • Phone: 215-601-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC009877
License Number StatePA

VIII. Authorized Official

Name: DR. DEREK JORDAN GEARHART
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 215-601-8831