MEDICARE: KURT KLINE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC010529	PA

General Provider Information

NPI Number	:	1740586007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT KLINE D.C.

Provider Business Mailing Address
First Line	:	253 WEST MOUNTAIN RD
Second Line	:
City	:	HEGINS
State	:	PA
Zip	:	17938
Country	:	US
Telephone Number	:	717-365-4052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 W MAPLE ST
Second Line	:
City	:	VALLEY VIEW
State	:	PA
Zip	:	17983-9504
Country	:	US
Telephone Number	:	570-573-9504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	11/10/2016

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