Healthcare Provider Details

I. General information

NPI: 1497954408
Provider Name (Legal Business Name): JARL KLEINMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 QUARTERMASTER CT
JEFFERSONVILLE IN
47130-3623
US

IV. Provider business mailing address

85 QUARTEMASTER CT
JEFFERSONVILLE IN
47130
US

V. Phone/Fax

Practice location:
  • Phone: 812-218-9133
  • Fax: 812-285-1882
Mailing address:
  • Phone: 812-218-9133
  • Fax: 812-285-1882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4873
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: