Provider Demographics
NPI:1689620213
Name:KLEINPETER PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:KLEINPETER PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KLEINPETER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:225-658-7751
Mailing Address - Street 1:1219 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2347
Mailing Address - Country:US
Mailing Address - Phone:225-658-7751
Mailing Address - Fax:225-658-7753
Practice Address - Street 1:1219 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2347
Practice Address - Country:US
Practice Address - Phone:225-658-7751
Practice Address - Fax:225-658-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CD22Medicare ID - Type Unspecified