Provider Demographics
NPI:1245206051
Name:KLOUD, SUZANNE HILARY (DC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:HILARY
Last Name:KLOUD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317
Mailing Address - Country:US
Mailing Address - Phone:610-459-4114
Mailing Address - Fax:610-459-2938
Practice Address - Street 1:301 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317
Practice Address - Country:US
Practice Address - Phone:610-459-4114
Practice Address - Fax:610-459-2938
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000203111N00000X
PADC001997L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KL 136384Medicare ID - Type Unspecified
T29475Medicare UPIN