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General NPI Number Information
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NPI Number | 1366896516
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Entity Type | Organization
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Legal Business Name | CLEAR ROUTE HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 2902 N ORANGE AVE 205
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City | ORLANDO
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State | FL
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Zip | 32804-4605
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Country | US
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Telephone | 407-286-5926
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Fax |
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Provider Business Mailing Address
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Address Line | 2902 N ORANGE AVE 205
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City | ORLANDO
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State | FL
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Zip | 32804-4605
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Country | US
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Telephone | 407-286-5926
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JOEL DAYTON
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Credential | D.C.
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Telephone | 407-286-5926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11820
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License Number State | FL
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