Provider Demographics
NPI:1225219181
Name:AUDIE G. KLINGLER DC
Entity Type:Organization
Organization Name:AUDIE G. KLINGLER DC
Other - Org Name:ALLEGANY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDIE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KLINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-777-0110
Mailing Address - Street 1:203 GREENE ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2877
Mailing Address - Country:US
Mailing Address - Phone:301-777-0110
Mailing Address - Fax:301-722-2982
Practice Address - Street 1:203 GREENE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2877
Practice Address - Country:US
Practice Address - Phone:301-777-0110
Practice Address - Fax:301-722-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5669650001Medicare NSC