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General NPI Number Information
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NPI Number | 1114844107
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Entity Type | Organization
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Legal Business Name | MAIN LINE NUTRITION THERAPY, LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 127 BARTON DR
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City | SPRING CITY
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State | PA
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Zip | 19475-3415
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Country | US
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Telephone | 484-222-3024
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Fax |
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Provider Business Mailing Address
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Address Line | 127 BARTON DR
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City | SPRING CITY
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State | PA
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Zip | 19475-3415
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Country | US
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Telephone | 484-222-3024
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE YAEGER
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Credential | MS, RD, LDN
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Telephone | 484-222-3024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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