Provider Demographics
NPI:1629378690
Name:KLINE, ANDREW JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:KLINE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 E HARMONY RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3297
Mailing Address - Country:US
Mailing Address - Phone:970-223-2556
Mailing Address - Fax:970-223-7255
Practice Address - Street 1:1426 E HARMONY RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3297
Practice Address - Country:US
Practice Address - Phone:970-223-2556
Practice Address - Fax:970-223-7255
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist