Provider Demographics
NPI:1831399005
Name:KLOPFENSTEIN, MARSHA LYN
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:LYN
Last Name:KLOPFENSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11809 COLONY LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-2046
Mailing Address - Country:US
Mailing Address - Phone:727-856-2706
Mailing Address - Fax:
Practice Address - Street 1:681 BEVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1951
Practice Address - Country:US
Practice Address - Phone:800-330-7711
Practice Address - Fax:866-426-2811
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23416171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor