Provider Demographics
NPI:1003062563
Name:KLOTZ, TERESA SWEENEY (RVT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:SWEENEY
Last Name:KLOTZ
Suffix:
Gender:F
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 HAMMETT AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-3514
Mailing Address - Country:US
Mailing Address - Phone:757-587-1295
Mailing Address - Fax:
Practice Address - Street 1:9100 HAMMETT AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-3514
Practice Address - Country:US
Practice Address - Phone:757-587-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography