Provider Demographics
NPI:1922148485
Name:KLIONSKY, LOUIS D (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:D
Last Name:KLIONSKY
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 1:1840 FOREST HILL BLVD
Mailing Address - Street 2:#105
Mailing Address - City:WPB
Mailing Address - State:FL
Mailing Address - Zip Code:33406
Mailing Address - Country:US
Mailing Address - Phone:561-439-5555
Mailing Address - Fax:561-439-5277
Practice Address - Street 1:1840 FOREST HILL BLVD
Practice Address - Street 2:#105
Practice Address - City:WPB
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-439-5555
Practice Address - Fax:561-439-5277
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55872Medicare UPIN
FL88539Medicare PIN