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General NPI Number Information
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NPI Number | 1811783640
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Entity Type | Individual
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Provider Name | JACOB KLEIN
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Gender |
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 333 W 5TH ST
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City | WACONIA
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State | MN
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Zip | 55387-1720
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Country | US
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Telephone | 952-442-7363
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Fax |
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Provider Business Mailing Address
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Address Line | 386 MEADOW LN
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City | NORWOOD YOUNG AMERICA
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State | MN
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Zip | 55397-4508
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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