Provider Demographics
NPI:1598922486
Name:KLEIN, KIM J (MPT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 TOWERS ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1347
Mailing Address - Country:US
Mailing Address - Phone:310-214-9996
Mailing Address - Fax:310-214-9996
Practice Address - Street 1:5225 TOWERS ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1347
Practice Address - Country:US
Practice Address - Phone:310-214-9996
Practice Address - Fax:310-214-9996
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist