Healthcare Provider Details

I. General information

NPI: 1083529994
Provider Name (Legal Business Name): JOHANNA KLUEMPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13375 UNIVERSITY AVE STE 103
CLIVE IA
50325-8262
US

IV. Provider business mailing address

13375 UNIVERSITY AVE STE 103
CLIVE IA
50325-8262
US

V. Phone/Fax

Practice location:
  • Phone: 515-216-0919
  • Fax:
Mailing address:
  • Phone: 515-216-0919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number120421
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: