Provider Demographics
NPI:1659997005
Name:KLEMAN, MICHELLE LYNN (OD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:KLEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:KALIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45853-0312
Mailing Address - Country:US
Mailing Address - Phone:419-230-6158
Mailing Address - Fax:
Practice Address - Street 1:15840 MEDICAL DR S STE A
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-7833
Practice Address - Country:US
Practice Address - Phone:419-422-6190
Practice Address - Fax:419-423-3235
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006903152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist