Provider Demographics
NPI:1194151951
Name:KLEPZIG NATURAL HEALING CLINIC, INC.
Entity type:Organization
Organization Name:KLEPZIG NATURAL HEALING CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:KLEPZIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC,DIPL AC,LAC
Authorized Official - Phone:217-345-1416
Mailing Address - Street 1:35 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-2950
Mailing Address - Country:US
Mailing Address - Phone:217-345-1416
Mailing Address - Fax:217-345-1460
Practice Address - Street 1:35 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2950
Practice Address - Country:US
Practice Address - Phone:217-345-1416
Practice Address - Fax:217-345-1460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.008290111NN1001X
IL198.000357171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty