Provider Demographics
NPI:1427643246
Name:KLINETOBE, MADELINE (RDN)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:KLINETOBE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6683 PAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-9400
Mailing Address - Country:US
Mailing Address - Phone:270-748-1879
Mailing Address - Fax:
Practice Address - Street 1:6683 PAYETTE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-9400
Practice Address - Country:US
Practice Address - Phone:270-748-1879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered