MEDICARE: VICTORIA SUZANNE KLUMP PT, 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
1	225100000X	Physical Therapist	2020016706	MO

General Provider Information

NPI Number	:	1770100356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA SUZANNE KLUMP PT, DPT

Provider Business Mailing Address
First Line	:	22 MISTY RIDGE CT
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-7279
Country	:	US
Telephone Number	:	636-443-5020
Fax Number	:	314-328-5610

Provider Business Practice Location Address
First Line	:	22 MISTY RIDGE CT
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-7279
Country	:	US
Telephone Number	:	636-443-5020
Fax Number	:	314-328-5610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2020
Last Update Date	:	02/10/2026

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