Provider Demographics
NPI:1760722060
Name:KLEPPER, RAY DEWEY (P,T,)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:DEWEY
Last Name:KLEPPER
Suffix:
Gender:M
Credentials:P,T,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5537 BLACK OLIVE DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4609
Mailing Address - Country:US
Mailing Address - Phone:530-877-7744
Mailing Address - Fax:530-877-7770
Practice Address - Street 1:5537 BLACK OLIVE DR
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4609
Practice Address - Country:US
Practice Address - Phone:530-877-7744
Practice Address - Fax:530-877-7770
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist