Healthcare Provider Details

I. General information

NPI: 1528489747
Provider Name (Legal Business Name): KATHRYN KLAVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 FOOTBRIDGE RD
BELFAST ME
04915-7206
US

IV. Provider business mailing address

134 FRENCHMANS HILL RD
BAR HARBOR ME
04609-7739
US

V. Phone/Fax

Practice location:
  • Phone: 207-338-5307
  • Fax:
Mailing address:
  • Phone: 207-266-7986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4083
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: