Provider Demographics
NPI:1780013375
Name:KLEIN, NATHANAEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHANAEL
Middle Name:JOSEPH
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 1:580 STATE ROUTE 690
Mailing Address - Street 2:
Mailing Address - City:SPRING BROOK TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18444-6551
Mailing Address - Country:US
Mailing Address - Phone:570-675-3833
Mailing Address - Fax:
Practice Address - Street 1:395 MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18504
Practice Address - Country:US
Practice Address - Phone:570-207-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor