Provider Demographics
NPI:1851849335
Name:KLIEVER, CODY
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:KLIEVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S HYLAND AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-7373
Mailing Address - Country:US
Mailing Address - Phone:712-541-9114
Mailing Address - Fax:
Practice Address - Street 1:212 S HYLAND AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7373
Practice Address - Country:US
Practice Address - Phone:712-541-9114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program