Provider Demographics
NPI:1811001910
Name:KLINE, ERIN WELLS (DC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:WELLS
Last Name:KLINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4314 EILEEN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2633
Mailing Address - Country:US
Mailing Address - Phone:571-264-4737
Mailing Address - Fax:
Practice Address - Street 1:4314 EILEEN CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2633
Practice Address - Country:US
Practice Address - Phone:571-264-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA104236OtherANTHEM
VA004175S58Medicare ID - Type UnspecifiedMEDICARE