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General NPI Number Information
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NPI Number | 1922602523
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Entity Type | Individual
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Provider Name | LAURA LEE KLOTZ L.AC
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Gender | Female
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Dates
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Enumeration Date | 11/24/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 838 W DESOTO ST STE 4D
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City | CLERMONT
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State | FL
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Zip | 34711-2110
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Country | US
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Telephone | 352-536-4992
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Fax | 352-218-1613
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Provider Business Mailing Address
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Address Line | 104 E CHESTER ST
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City | MINNEOLA
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State | FL
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Zip | 34715-8712
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Country | US
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Telephone | 352-536-4992
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Fax | 352-218-1613
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP4173
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License Number State | FL
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