Healthcare Provider Details

I. General information

NPI: 1750939427
Provider Name (Legal Business Name): MARY KLEIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 SALEM RD SW
ROCHESTER MN
55902-0993
US

IV. Provider business mailing address

PO BOX 7197
ROCHESTER MN
55903-7197
US

V. Phone/Fax

Practice location:
  • Phone: 507-322-3460
  • Fax:
Mailing address:
  • Phone: 507-322-3460
  • Fax: 507-322-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number11590
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: