Provider Demographics
NPI:1386617769
Name:KLAES, CHRISTOPHER J (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:KLAES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-0747
Mailing Address - Country:US
Mailing Address - Phone:812-522-2240
Mailing Address - Fax:812-522-9582
Practice Address - Street 1:1400 W 2ND ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2224
Practice Address - Country:US
Practice Address - Phone:812-522-2240
Practice Address - Fax:812-522-9582
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000699A111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100333400AMedicaid
IN380810BMedicare ID - Type Unspecified
IN100333400AMedicaid