MEDICARE: DR. JOHN S KLEPTACH DC

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	2311	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000140409	OTHER	OH	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417020447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN S KLEPTACH DC

Provider Business Mailing Address
First Line	:	1170 S MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4272
Country	:	US
Telephone Number	:	330-494-7158
Fax Number	:	330-494-7184

Provider Business Practice Location Address
First Line	:	1170 S MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-4272
Country	:	US
Telephone Number	:	330-494-7158
Fax Number	:	330-494-7184

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	02/18/2010

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