Provider Demographics
NPI:1740586007
Name:KLINE, KURT (DC)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:KLINE
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 1:253 WEST MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HEGINS
Mailing Address - State:PA
Mailing Address - Zip Code:17938
Mailing Address - Country:US
Mailing Address - Phone:717-365-4052
Mailing Address - Fax:
Practice Address - Street 1:1111 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:PA
Practice Address - Zip Code:17983-9504
Practice Address - Country:US
Practice Address - Phone:570-573-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor