Provider Demographics
NPI:1326823717
Name:KLINDER, HEIDI M (LMT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:KLINDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19612 W 130TH ST
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8434
Mailing Address - Country:US
Mailing Address - Phone:440-572-2225
Mailing Address - Fax:
Practice Address - Street 1:19612 W 130TH ST
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-8434
Practice Address - Country:US
Practice Address - Phone:440-572-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17764225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist