Individual
ALYWIN E KLUTTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(417) 533-6100
(417) 533-6021
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4B87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201692530
—
MO
Enumeration date
06/21/2005
Last updated
08/20/2015
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