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NPI Code Detail

MEDICARE: WENDY MARIE KLEMS

MEDICARE: WENDY MARIE KLEMS
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 Therapist2171NE
2225100000XPhysical TherapistPT 007581OH
3225100000XPhysical TherapistQA 00778300NJ

General Provider Information

NPI Number : 1477741064
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MARIE KLEMS
Provider Business Mailing Address
First Line : 7540 N 19TH AVE STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-7967
Country : US
Telephone Number : 888-873-4221
Fax Number : 888-543-2289
Provider Business Practice Location Address
First Line : 1100 1ST ST
Second Line :
City : MILFORD
State : NE
Zip : 68405-9708
Country : US
Telephone Number : 402-761-2261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2007
Last Update Date : 10/09/2007

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Directions to “ WENDY MARIE KLEMS ” Practice Location

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