Provider Demographics
NPI:1619148608
Name:THOMAS M. KLINE D.C.,P.A.
Entity Type:Organization
Organization Name:THOMAS M. KLINE D.C.,P.A.
Other - Org Name:KLINE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-843-1156
Mailing Address - Street 1:11637 TERRACE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3706
Mailing Address - Country:US
Mailing Address - Phone:301-843-1156
Mailing Address - Fax:301-843-5917
Practice Address - Street 1:11637 TERRACE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3706
Practice Address - Country:US
Practice Address - Phone:301-843-1156
Practice Address - Fax:301-843-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1197PT111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR261OtherCAREFIRST BCBS
MDR261OtherCAREFIRST BCBS
MDU 03143Medicare UPIN