Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 12843 - 24 | WI |
NPI | 1003213349 |
---|---|
Provider Name | Matthew Klein |
First Address | Franklin, WI 53132-1151 |
Second Address | Two Rivers, WI 54241-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2014 |
Last Update Date | 02/12/2014 |