Provider Demographics
NPI:1720567878
Name:KLEIN, ALFRED GUSTAV (PT)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:GUSTAV
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1611
Mailing Address - Country:US
Mailing Address - Phone:734-240-1950
Mailing Address - Fax:
Practice Address - Street 1:407 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1611
Practice Address - Country:US
Practice Address - Phone:734-240-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist