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General NPI Number Information
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NPI Number | 1487729166
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Entity Type | Organization
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Legal Business Name | KLINGERT CHIROPRACTIC CENTER, PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16816 N 35TH AVE STE 8
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City | PHOENIX
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State | AZ
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Zip | 85053-2977
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Country | US
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Telephone | 602-843-3788
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Fax | 602-843-6485
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Provider Business Mailing Address
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Address Line | 16816 N 35TH AVE STE 8
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City | PHOENIX
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State | AZ
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Zip | 85053-2977
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Country | US
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Telephone | 602-843-3788
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Fax | 602-843-6485
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Authorized Official
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Title or Position | OWNER, CHIROPRACTOR
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Name | MARK J. KLINGERT
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Credential | DC
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Telephone | 602-843-3788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3372
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License Number State | AZ
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