Provider Demographics
NPI:1346660115
Name:CASEY KLINGERT DC LLC
Entity Type:Organization
Organization Name:CASEY KLINGERT DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KLINGERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-412-7898
Mailing Address - Street 1:1319 OLD ZION RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7638
Mailing Address - Country:US
Mailing Address - Phone:609-412-7898
Mailing Address - Fax:
Practice Address - Street 1:1319 OLD ZION RD
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-7638
Practice Address - Country:US
Practice Address - Phone:609-653-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00660200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty