Provider Demographics
NPI:1952810624
Name:KLITSCH FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:KLITSCH FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KLITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-216-8793
Mailing Address - Street 1:173 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1310
Mailing Address - Country:US
Mailing Address - Phone:1610-467-7559
Mailing Address - Fax:
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1212
Practice Address - Country:US
Practice Address - Phone:610-262-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty