MEDICARE: CALI MARIE KLIMKE PT, MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2238	NV

General Provider Information

NPI Number	:	1568768794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALI MARIE KLIMKE PT, MPT

Provider Business Mailing Address
First Line	:	5109 RUFFLED GROUSE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1587
Country	:	US
Telephone Number	:	702-595-9273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 S JONES BLVD
Second Line	:	SUTIE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6792
Country	:	US
Telephone Number	:	702-360-1137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2011
Last Update Date	:	02/05/2011

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