Provider Demographics
NPI:1093071946
Name:KLIER, JITKA (MPT)
Entity Type:Individual
Prefix:
First Name:JITKA
Middle Name:
Last Name:KLIER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 W AVENUE Q
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3893
Mailing Address - Country:US
Mailing Address - Phone:661-949-8643
Mailing Address - Fax:661-947-1631
Practice Address - Street 1:647 W AVENUE Q
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3893
Practice Address - Country:US
Practice Address - Phone:661-949-8643
Practice Address - Fax:661-947-1631
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32622261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy