Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT-004485 | KY |
N | 2251S0007X | Physical Therapist - Sports | PT-004485 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | PT-004485 | KY |
NPI | 1093887226 |
---|---|
Provider Name | Mark J. Kluemper |
First Address | Lexington, KY 40504-3756 |
Second Address | Lexington, KY 40504-3756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |