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General NPI Number Information
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NPI Number | 1336284314
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Entity Type | Organization
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Legal Business Name | KLEMER CHIROPRACTIC OFFICE A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 17400 IRVINE BLVD SUITE L
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City | TUSTIN
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State | CA
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Zip | 92780-3030
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Country | US
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Telephone | 714-508-1112
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Fax | 714-508-3653
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Provider Business Mailing Address
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Address Line | 17400 IRVINE BLVD SUITE L
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City | TUSTIN
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State | CA
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Zip | 92780-3030
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Country | US
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Telephone | 714-508-1112
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Fax | 714-508-3653
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M VOSTMYER
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Credential | D.C.
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Telephone | 714-508-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 19318
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License Number State | CA
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