Provider Demographics
NPI:1902985260
Name:KLUMPP-RICHARD, KATY T (DC)
Entity Type:Individual
Prefix:DR
First Name:KATY
Middle Name:T
Last Name:KLUMPP-RICHARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KATY
Other - Middle Name:KLUMPP
Other - Last Name:MOUTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:110 1/2 W. 8TH ST.
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526
Mailing Address - Country:US
Mailing Address - Phone:337-783-2223
Mailing Address - Fax:337-788-0888
Practice Address - Street 1:110 1/2 W. 8TH ST.
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526
Practice Address - Country:US
Practice Address - Phone:337-783-2223
Practice Address - Fax:337-788-0888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1404OtherLOUISIANA CHIROPRACTIC LICENSE
LA3A039Medicare PIN