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NPI Code Detail

MEDICARE: DR. MATTHEW JAMES KLINKER DPT

MEDICARE: DR. MATTHEW JAMES KLINKER DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1053758052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW JAMES KLINKER DPT
Provider Business Mailing Address
First Line : 5700 MOCKINGBIRD LN
Second Line :
City : GREENDALE
State : WI
Zip : 53129-1442
Country : US
Telephone Number : 708-704-5470
Fax Number :
Provider Business Practice Location Address
First Line : 5700 MOCKINGBIRD LN
Second Line :
City : GREENDALE
State : WI
Zip : 53129-1442
Country : US
Telephone Number : 708-704-5470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2013
Last Update Date : 05/30/2013

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Directions to “ DR. MATTHEW JAMES KLINKER DPT” Practice Location

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