Individual
MARK S KLEZMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
51 DIAUTO DR, RANDOLPH, MA 02368-4501
(781) 986-6443
(781) 986-4837
Mailing address
51 DIAUTO DR, RANDOLPH, MA 02368-4501
(781) 986-6443
(781) 986-4837
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
521
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y35346
BLUE CROSS
MA
Enumeration date
03/23/2006
Last updated
08/10/2011
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