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General NPI Number Information
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NPI Number | 1588706097
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Entity Type | Individual
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Provider Name | PATRICK TODD KLESTER P.T.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8080 BLUEBONNET BLVD SUITE 110
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City | BATON ROUGE
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State | LA
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Zip | 70810-7827
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Country | US
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Telephone | 225-408-7992
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Fax | 225-408-7989
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Provider Business Mailing Address
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Address Line | 16243 MADISON CT
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-4988
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Country | US
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Telephone | 225-622-5138
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 04125
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License Number State | LA
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