Provider Demographics
NPI:1679130801
Name:KLAUS SPORTS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:KLAUS SPORTS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:KLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-331-0638
Mailing Address - Street 1:3070 DREWSKY LN UNIT 103
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-0128
Mailing Address - Country:US
Mailing Address - Phone:803-331-0638
Mailing Address - Fax:
Practice Address - Street 1:9301 FORSYTH PARK DR STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3957
Practice Address - Country:US
Practice Address - Phone:704-714-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty