Organization
KLINEDINST CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY L. KLINEDINST D.C. (CHIROPRACTOR/OWNER)
(309) 647-8030
Entity
Organization
Contact information
Practice address
106 MARTIN AVE, CANTON, IL 61520-2519
(309) 647-8030
(309) 647-5902
Mailing address
106 MARTIN AVE, CANTON, IL 61520-2519
(309) 647-8030
(309) 647-5902
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-004195
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL3472
MEDICARE PTAN
IL
Enumeration date
07/20/2007
Last updated
01/06/2015
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