Provider Demographics
NPI:1245207810
Name:KLONEL, KENT E (DC)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:E
Last Name:KLONEL
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 1:462 W CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2415
Mailing Address - Country:US
Mailing Address - Phone:407-682-6809
Mailing Address - Fax:407-682-3020
Practice Address - Street 1:462 W CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2415
Practice Address - Country:US
Practice Address - Phone:407-682-6809
Practice Address - Fax:407-682-3020
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor