Healthcare Provider Details

I. General information

NPI: 1205405024
Provider Name (Legal Business Name): CASSIDY F KLEIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S UNION ST UNIT B
TRAVERSE CITY MI
49684-2665
US

IV. Provider business mailing address

309 W FRONT ST UNIT 223
TRAVERSE CITY MI
49684-2751
US

V. Phone/Fax

Practice location:
  • Phone: 231-883-2323
  • Fax: 231-216-7704
Mailing address:
  • Phone: 231-883-2323
  • Fax: 231-216-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501304433
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: