Provider Demographics
NPI:1326465113
Name:KLINKER, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KLINKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 BURKHART AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLS POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43348-9552
Mailing Address - Country:US
Mailing Address - Phone:419-202-0042
Mailing Address - Fax:
Practice Address - Street 1:140 BURKHART AVE
Practice Address - Street 2:
Practice Address - City:RUSSELLS POINT
Practice Address - State:OH
Practice Address - Zip Code:43348-9552
Practice Address - Country:US
Practice Address - Phone:419-202-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.08190225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant