Provider Demographics
NPI:1518733195
Name:KLAUER, PATRICK RYAN
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RYAN
Last Name:KLAUER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29752 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2145
Mailing Address - Country:US
Mailing Address - Phone:440-218-0073
Mailing Address - Fax:
Practice Address - Street 1:29752 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-2145
Practice Address - Country:US
Practice Address - Phone:440-218-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty