Provider Demographics
NPI:1639510506
Name:CLINE, CHRISTOPHER HEATH (LPN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:HEATH
Last Name:CLINE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-9462
Mailing Address - Country:US
Mailing Address - Phone:740-395-1568
Mailing Address - Fax:
Practice Address - Street 1:613 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-9462
Practice Address - Country:US
Practice Address - Phone:740-395-1568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH142929164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse