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General NPI Number Information
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NPI Number | 1659462364
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Entity Type | Organization
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Legal Business Name | C.A.F.E. OF LIFE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 4540 HAMILTON BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18103-6195
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Country | US
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Telephone | 610-366-1336
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Fax | 610-366-1397
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Provider Business Mailing Address
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Address Line | 4540 HAMILTON BLVD
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City | ALLENTOWN
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State | PA
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Zip | 18103-6195
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Country | US
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Telephone | 610-366-1336
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Fax | 610-366-1397
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALFONSO DI CARLO
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Credential | D.C.
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Telephone | 610-366-1336
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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 | DC007846-L
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License Number State | PA
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