Provider Demographics
NPI:1710250303
Name:KLAFF SPORTS PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:KLAFF SPORTS PHYSICAL THERAPY, INC
Other - Org Name:KLAFF SPORTS PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:443-802-1161
Mailing Address - Street 1:2410 SYLVALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1539
Mailing Address - Country:US
Mailing Address - Phone:443-621-5961
Mailing Address - Fax:
Practice Address - Street 1:625 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5101
Practice Address - Country:US
Practice Address - Phone:443-595-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MDA3646225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty