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General NPI Number Information
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NPI Number | 1194757609
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Entity Type | Organization
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Legal Business Name | KARL KLEINAU
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 246 N NEW HOPE RD
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City | GASTONIA
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State | NC
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Zip | 28054-4745
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Country | US
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Telephone | 707-867-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 246 N NEW HOPE RD PO BOX 5131
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City | GASTONIA
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State | NC
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Zip | 28054-4745
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Country | US
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Telephone | 707-867-1392
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARL JURGEN KLEINAU
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Credential | O.D.
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Telephone | 704-867-1392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1392
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License Number State | NC
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