Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 2008018158 | MO |
Y | 225200000X | Physical Therapy Assistant | 4230 | NC |
NPI | 1003064775 |
---|---|
Provider Name | Mrs. Kelly Anne Kloepping |
First Address | Greenville, NC 27858-5758 |
Second Address | Greenville, NC 27858-5758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2008 |
Last Update Date | 10/07/2009 |