Provider Demographics
NPI:1407910078
Name:KLEIN, ANDREW J (M LIC AC DIPL OM)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:M
Credentials:M LIC AC DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033-0028
Mailing Address - Country:US
Mailing Address - Phone:603-673-3878
Mailing Address - Fax:
Practice Address - Street 1:27 LAKE POTANIPO RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:NH
Practice Address - Zip Code:03033-2230
Practice Address - Country:US
Practice Address - Phone:603-673-3878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH128171100000X
CA8938171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist