Provider Demographics
NPI:1285158204
Name:KLEIN, MOLLY KATHERINE (DC)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:KATHERINE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 S MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:IL
Mailing Address - Zip Code:62285-1795
Mailing Address - Country:US
Mailing Address - Phone:618-795-3842
Mailing Address - Fax:
Practice Address - Street 1:13 S MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:IL
Practice Address - Zip Code:62285-1795
Practice Address - Country:US
Practice Address - Phone:618-795-3842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor