Provider Demographics
NPI:1043298573
Name:KLOER, JEFFREY M (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:KLOER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11801 MENAUL BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2420
Mailing Address - Country:US
Mailing Address - Phone:505-271-9616
Mailing Address - Fax:505-271-8050
Practice Address - Street 1:11719 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1790
Practice Address - Country:US
Practice Address - Phone:505-345-8050
Practice Address - Fax:505-343-8050
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM25800736Medicaid
NM25800736Medicaid
NM34M732501Medicare PIN