Provider Demographics
NPI:1215009584
Name:KLINGENSMITH, RICHARD D (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:KLINGENSMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YEAGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17099-9635
Mailing Address - Country:US
Mailing Address - Phone:717-248-1818
Mailing Address - Fax:
Practice Address - Street 1:217 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9635
Practice Address - Country:US
Practice Address - Phone:717-248-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001580L111N00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKL85056Medicare UPIN
PAKL85056Medicare PIN