Provider Demographics
NPI:1396202701
Name:KLUG CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KLUG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-331-0550
Mailing Address - Street 1:906 72ND AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-1203
Mailing Address - Country:US
Mailing Address - Phone:763-442-0026
Mailing Address - Fax:
Practice Address - Street 1:9405 36TH AVE N STE E
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1786
Practice Address - Country:US
Practice Address - Phone:763-331-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty