Provider Demographics
NPI:1083057855
Name:KLEIN, WILLIAM HUNTLEY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HUNTLEY
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5140
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-5140
Mailing Address - Country:US
Mailing Address - Phone:970-949-5437
Mailing Address - Fax:970-949-0576
Practice Address - Street 1:0072 BEAVER CREEK PL
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-5140
Practice Address - Country:US
Practice Address - Phone:970-949-5437
Practice Address - Fax:970-949-0576
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist