Provider Demographics
NPI:1720129695
Name:KLEMA, TERRELL G (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRELL
Middle Name:G
Last Name:KLEMA
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 1:296 MAIN ST., PO BOX 77
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03603-0077
Mailing Address - Country:US
Mailing Address - Phone:603-826-5220
Mailing Address - Fax:603-826-5220
Practice Address - Street 1:296 MAIN ST.
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:NH
Practice Address - Zip Code:03603-0077
Practice Address - Country:US
Practice Address - Phone:603-826-5220
Practice Address - Fax:603-826-5220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5950200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH05Y004162NH01OtherBCBS
NHKLRE6148Medicare ID - Type Unspecified