MEDICARE: KLESMIT HEALTH CARE SERVICES, INC.

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	4251	TX

General Provider Information

NPI Number	:	1760665970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLESMIT HEALTH CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	1014 S MAIN ST
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75137-2320
Country	:	US
Telephone Number	:	972-296-1566
Fax Number	:	972-296-3060

Provider Business Practice Location Address
First Line	:	1014 S MAIN ST
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75137-2320
Country	:	US
Telephone Number	:	972-296-1566
Fax Number	:	972-296-3060

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY RICHARD KLESMIT
Credential	:	DC
Telephone Number	:	972-296-1566

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	06/16/2008

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