Provider Demographics
NPI:1841486180
Name:DLC2,INC
Entity type:Organization
Organization Name:DLC2,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:CHAR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:937-432-0099
Mailing Address - Street 1:450 N MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4490
Mailing Address - Country:US
Mailing Address - Phone:937-432-0099
Mailing Address - Fax:937-432-0600
Practice Address - Street 1:450 N MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4490
Practice Address - Country:US
Practice Address - Phone:937-432-0099
Practice Address - Fax:937-432-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty