Provider Demographics
NPI:1023439072
Name:GLENN A KLINE
Entity type:Organization
Organization Name:GLENN A KLINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-394-5401
Mailing Address - Street 1:90 GOOD DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4360
Mailing Address - Country:US
Mailing Address - Phone:717-394-5401
Mailing Address - Fax:717-394-6890
Practice Address - Street 1:90 GOOD DR
Practice Address - Street 2:SUITE 301
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4360
Practice Address - Country:US
Practice Address - Phone:717-394-5401
Practice Address - Fax:717-394-6890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006448L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty