Healthcare Provider Details

I. General information

NPI: 1326280355
Provider Name (Legal Business Name): DAVID PATRICK KLING R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 SHELTERED BROOK DR
HURON OH
44839-2824
US

IV. Provider business mailing address

1129 SHELTERED BROOK DR
HURON OH
44839-2824
US

V. Phone/Fax

Practice location:
  • Phone: 419-515-1006
  • Fax:
Mailing address:
  • Phone: 419-515-1006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03117360
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: