MEDICARE: MICHAEL BRADLEY KLEPSER DPT

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	225100000X	Physical Therapist	1178018	TX

General Provider Information

NPI Number	:	1366613051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BRADLEY KLEPSER DPT

Provider Business Mailing Address
First Line	:	PO BOX 2427
Second Line	:
City	:	FREDERICKSBURG
State	:	TX
Zip	:	78624-1906
Country	:	US
Telephone Number	:	830-997-2001
Fax Number	:	830-997-0781

Provider Business Practice Location Address
First Line	:	1004 MARBLE HTS STE B
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4543
Country	:	US
Telephone Number	:	830-798-3497
Fax Number	:

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

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	03/25/2008

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