Provider Demographics
NPI:1043860315
Name:KLETTKE, ERIN LUISE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:LUISE
Last Name:KLETTKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLOMBA DR STE 5
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-1275
Mailing Address - Country:US
Mailing Address - Phone:716-298-2249
Mailing Address - Fax:
Practice Address - Street 1:1 COLOMBA DR STE 5
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-1275
Practice Address - Country:US
Practice Address - Phone:716-298-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist