Healthcare Provider Details

I. General information

NPI: 1699542696
Provider Name (Legal Business Name): GREGORY ROBERT KLEIN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 PACIFIC AVE STE 104B
FOREST GROVE OR
97116-3100
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 503-395-1232
  • Fax:
Mailing address:
  • Phone: 423-702-4389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008957
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP057797T
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP038562T
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20676
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: