Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 2005018594 | MO |
NPI | 1558760587 |
---|---|
Provider Name | John Joseph Klay |
First Address | Republic, MO 65738-1701 |
Second Address | Kansas City, MO 64128-2226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2014 |
Last Update Date | 14/08/2014 |