Provider Demographics
NPI:1891751962
Name:KLAUS, BRYAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:THOMAS
Last Name:KLAUS
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 1:111 WHITEHEAD LN
Mailing Address - Street 2:STE 100
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2756
Mailing Address - Country:US
Mailing Address - Phone:412-357-2640
Mailing Address - Fax:412-373-1982
Practice Address - Street 1:111 WHITEHEAD LN
Practice Address - Street 2:STE 100
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2756
Practice Address - Country:US
Practice Address - Phone:724-591-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA348459OtherHIGHMARK BC/BS
PA039101Medicare ID - Type Unspecified
PAU80861Medicare UPIN