Provider Demographics
NPI:1588639173
Name:KLINGERT FAMILY CHIROPRACTIC CENTER P C
Entity Type:Organization
Organization Name:KLINGERT FAMILY CHIROPRACTIC CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLINGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-653-1100
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:609-653-1100
Mailing Address - Fax:609-653-1820
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:609-653-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00151000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0074967000OtherAMERIHEALTH GROUP NUMBER
NJ0932257OtherAETNA
NJ=========OtherTAX ID
NJW87246Medicare UPIN
NJ055746Medicare PIN