Provider Demographics
NPI:1609393743
Name:KLUG, CHARA (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARA
Middle Name:
Last Name:KLUG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9405 36TH AVE N STE E
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1786
Mailing Address - Country:US
Mailing Address - Phone:763-331-0550
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:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6397111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist