Provider Demographics
NPI:1629158225
Name:KLEIN, JOEL ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ALEXANDER
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1324
Mailing Address - Country:US
Mailing Address - Phone:610-525-2209
Mailing Address - Fax:610-525-1503
Practice Address - Street 1:100 QUAKER LN
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1324
Practice Address - Country:US
Practice Address - Phone:610-525-2209
Practice Address - Fax:610-525-1503
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001784L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT27123Medicare UPIN
PA24173Medicare ID - Type Unspecified