Provider Demographics
NPI:1770837361
Name:KLEMM, ELIZABETH CUNNINGHAM (PT, MPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CUNNINGHAM
Last Name:KLEMM
Suffix:
Gender:F
Credentials:PT, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4095 STATE HIGHWAY 6 S
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9491
Mailing Address - Country:US
Mailing Address - Phone:979-690-1999
Mailing Address - Fax:
Practice Address - Street 1:4095 STATE HIGHWAY 6 S
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-9491
Practice Address - Country:US
Practice Address - Phone:979-690-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-04
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10596992251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic