MEDICARE: KLEIN CHIROPRACTIC CLINIC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1114129566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLEIN CHIROPRACTIC CLINIC

Provider Business Mailing Address
First Line	:	12812 101ST AVENUE CT E
Second Line	:	SUITE 104
City	:	PUYALLUP
State	:	WA
Zip	:	98373-9101
Country	:	US
Telephone Number	:	253-841-4457
Fax Number	:	253-841-8526

Provider Business Practice Location Address
First Line	:	12812 101ST AVENUE CT E
Second Line	:	SUITE 104
City	:	PUYALLUP
State	:	WA
Zip	:	98373-9101
Country	:	US
Telephone Number	:	253-841-4457
Fax Number	:	253-841-8526

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	JOSEPH PATRICK KLEIN
Credential	:	DC
Telephone Number	:	253-841-4457

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	08/22/2020

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