Provider Demographics
NPI:1508826371
Name:KLEEMAN, STEVEN MARK (ATC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MARK
Last Name:KLEEMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1198
Mailing Address - Country:US
Mailing Address - Phone:978-597-6167
Mailing Address - Fax:
Practice Address - Street 1:703 CHICOPEE ROW
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1455
Practice Address - Country:US
Practice Address - Phone:978-448-6362
Practice Address - Fax:978-448-0390
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer