Provider Demographics
NPI:1306305925
Name:KLUTTS, PAUL J (DOCS, CEO)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:J
Last Name:KLUTTS
Suffix:
Gender:M
Credentials:DOCS, CEO
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:J
Other - Last Name:KLUTTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:330 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-2340
Mailing Address - Country:US
Mailing Address - Phone:906-630-0529
Mailing Address - Fax:877-795-1376
Practice Address - Street 1:330 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-2340
Practice Address - Country:US
Practice Address - Phone:920-750-1174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No376J00000XNursing Service Related ProvidersHomemaker