Provider Demographics
NPI:1740597756
Name:KLEIN, LEANN MICHELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:MICHELLE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 MCCRACKEN PIKE
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9783
Mailing Address - Country:US
Mailing Address - Phone:606-776-7040
Mailing Address - Fax:
Practice Address - Street 1:8120 MCCRACKEN PIKE
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-9783
Practice Address - Country:US
Practice Address - Phone:606-776-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist