Provider Demographics
NPI:1356308647
Name:LOUIS D KLIONSKY DC PA
Entity Type:Organization
Organization Name:LOUIS D KLIONSKY DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLIONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-439-5555
Mailing Address - Street 1:1840 FOREST HILL BLVD
Mailing Address - Street 2:# 105
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406
Mailing Address - Country:US
Mailing Address - Phone:561-439-5555
Mailing Address - Fax:561-439-5277
Practice Address - Street 1:1840 FOREST HILL BLVD
Practice Address - Street 2:# 105
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-439-5555
Practice Address - Fax:561-439-5277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003150111N00000X
NYX2159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty