Provider Demographics
NPI:1164544326
Name:KLUMP, EMILY E (PT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:E
Last Name:KLUMP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 S EAST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2411
Mailing Address - Country:US
Mailing Address - Phone:517-990-6211
Mailing Address - Fax:517-990-6212
Practice Address - Street 1:2136 ROBINSON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3557
Practice Address - Country:US
Practice Address - Phone:517-750-2540
Practice Address - Fax:517-750-2044
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIEM012698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650C811590OtherBCBS
MIP00340832Medicare ID - Type UnspecifiedRR MEDICARE
MI650C811590OtherBCBS