Provider Demographics
NPI:1619263076
Name:KLUTHO, TONI (PD)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:
Last Name:KLUTHO
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 GULF SHORES PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-2819
Mailing Address - Country:US
Mailing Address - Phone:251-967-7002
Mailing Address - Fax:
Practice Address - Street 1:3820 GULF SHORES PKWY
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2819
Practice Address - Country:US
Practice Address - Phone:251-967-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist