Provider Demographics
NPI:1942318159
Name:KLINGERT, KERA ERIKA (DC)
Entity Type:Individual
Prefix:DR
First Name:KERA
Middle Name:ERIKA
Last Name:KLINGERT
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 1:16816 N 35 AVE
Mailing Address - Street 2:STE 8
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053
Mailing Address - Country:US
Mailing Address - Phone:602-843-3788
Mailing Address - Fax:602-843-6485
Practice Address - Street 1:16816 N 35 AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053
Practice Address - Country:US
Practice Address - Phone:602-843-3788
Practice Address - Fax:602-843-6485
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U97020Medicare UPIN
AZZ76555Medicare ID - Type Unspecified