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General NPI Number Information
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NPI Number | 1942839980
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Entity Type | Organization
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Legal Business Name | KLALLANDO PC
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 4830 CENTRAL PARK DR
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City | OKEMOS
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State | MI
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Zip | 48864-2089
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Country | US
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Telephone | 517-721-7639
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Fax |
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Provider Business Mailing Address
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Address Line | 5174 ROYCE RD
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City | WEBBERVILLE
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State | MI
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Zip | 48892-9760
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Country | US
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Telephone | 858-472-4052
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | DR. KYLE LAMONT ALLAN
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Credential | DO
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Telephone | 858-472-4052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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