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General NPI Number Information
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NPI Number | 1841462942
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Entity Type | Organization
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Legal Business Name | KLEIN CHIROPRACTIC P C
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 4720 YELM HWY SE
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City | LACEY
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State | WA
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Zip | 98503-4986
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Country | US
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Telephone | 360-491-4359
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Fax | 360-491-6417
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Provider Business Mailing Address
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Address Line | 4720 YELM HWY SE
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City | LACEY
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State | WA
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Zip | 98503-4986
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Country | US
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Telephone | 360-491-4359
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Fax | 360-491-6417
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER G KLEIN
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Credential | DC
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Telephone | 360-491-4359
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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 | CH00002026
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License Number State | WA
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