Provider Demographics
NPI:1568107571
Name:THE KLS EFFECT LLC
Entity Type:Organization
Organization Name:THE KLS EFFECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-716-5797
Mailing Address - Street 1:404 S BOULDER HWY # 91294
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7546
Mailing Address - Country:US
Mailing Address - Phone:702-716-5797
Mailing Address - Fax:
Practice Address - Street 1:404 S BOULDER HWY # 91294
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7546
Practice Address - Country:US
Practice Address - Phone:702-716-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier