=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841425774
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C & L FITCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2009
-----------------------------------------------------
Last Update Date | 03/25/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 47 JOHN DYER WAY
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18902-9615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-221-4254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 47 JOHN DYER WAY
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18902-9615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-221-4254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | DR. CHRISTPHER LEARN
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 267-221-4254
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC007716L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------