Provider Demographics
NPI:1932500816
Name:KLATT, DEREK W (DC)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:W
Last Name:KLATT
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 1:220 S CLIFF AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-2485
Mailing Address - Country:US
Mailing Address - Phone:605-767-1610
Mailing Address - Fax:
Practice Address - Street 1:220 S CLIFF AVE
Practice Address - Street 2:STE 102
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032-2485
Practice Address - Country:US
Practice Address - Phone:605-767-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor