Provider Demographics
NPI:1215365127
Name:KLIE, ANDREW (NREMT-P)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:KLIE
Suffix:
Gender:M
Credentials:NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-8356
Mailing Address - Country:US
Mailing Address - Phone:803-399-8247
Mailing Address - Fax:803-399-8230
Practice Address - Street 1:1448 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8356
Practice Address - Country:US
Practice Address - Phone:803-399-8247
Practice Address - Fax:803-399-8230
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC021229146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic