Provider Demographics
NPI:1700387131
Name:KLIER, KRISTIE DAWN (LMT)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:DAWN
Last Name:KLIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:KRISTIE
Other - Middle Name:DAWN
Other - Last Name:KLIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:100 W GRANT ST APT 5070
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3977
Mailing Address - Country:US
Mailing Address - Phone:407-808-5460
Mailing Address - Fax:
Practice Address - Street 1:30 W GRANT ST STE 129
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3982
Practice Address - Country:US
Practice Address - Phone:407-808-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA65426225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist