Provider Demographics
NPI:1164641056
Name:DR. WILLIAM KLEBER, D.C., P.C.
Entity Type:Organization
Organization Name:DR. WILLIAM KLEBER, D.C., P.C.
Other - Org Name:GATEWAY NATURAL MEDICINE & DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-532-2755
Mailing Address - Street 1:1211 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-9380
Mailing Address - Country:US
Mailing Address - Phone:970-532-2755
Mailing Address - Fax:
Practice Address - Street 1:1211 LAKE AVE
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-9380
Practice Address - Country:US
Practice Address - Phone:970-532-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3454111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC27693Medicare PIN