MEDICARE: KLIMICK ACUPUNCTURE LLC

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	171100000X	Acupuncturist	65.000160	OH

General Provider Information

NPI Number	:	1790010072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLIMICK ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	10979 REED HARTMAN HWY
Second Line	:	SUITE 129
City	:	CINCINNATI
State	:	OH
Zip	:	45242-2800
Country	:	US
Telephone Number	:	513-834-8173
Fax Number	:

Provider Business Practice Location Address
First Line	:	10979 REED HARTMAN HWY
Second Line	:	SUITE 129
City	:	CINCINNATI
State	:	OH
Zip	:	45242-2800
Country	:	US
Telephone Number	:	513-834-8173
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GIGI KLIMICK PEREIRA
Credential	:	L.AC.
Telephone Number	:	513-834-8173

Provider Enumeration Date	:	10/05/2009
Last Update Date	:	10/05/2009

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