MEDICARE: WILLIAM KLEIS MS, LP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP2973	MN

General Provider Information

NPI Number	:	1174511752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM KLEIS MS, LP, LLC

Provider Business Mailing Address
First Line	:	6741 ZUMBRO PL NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-8928
Country	:	US
Telephone Number	:	507-281-2115
Fax Number	:	507-289-5861

Provider Business Practice Location Address
First Line	:	300 3RD AVE SE
Second Line	:	SUITE 408
City	:	ROCHESTER
State	:	MN
Zip	:	55904-4619
Country	:	US
Telephone Number	:	507-281-2115
Fax Number	:	507-289-5861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2005
Last Update Date	:	07/08/2007

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Directions to “ WILLIAM KLEIS MS, LP, LLC” Practice Location

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