MEDICARE: ROBERT KLEFFMAN

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5501010951	OTHER	MI	LICENSE#

General Provider Information

NPI Number	:	1770692352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KLEFFMAN

Provider Business Mailing Address
First Line	:	36660 NEWBERRY ESTATES DR
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-8350
Country	:	US
Telephone Number	:	734-326-2346
Fax Number	:

Provider Business Practice Location Address
First Line	:	35591 CENTRAL CITY PKWY
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-6746
Country	:	US
Telephone Number	:	734-458-1820
Fax Number	:

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/08/2007

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