Provider Demographics
NPI:1861685117
Name:KLINKHAMMER, NANCY LEIGH (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LEIGH
Last Name:KLINKHAMMER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6017 E POWDER HOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-7468
Mailing Address - Country:US
Mailing Address - Phone:605-929-4588
Mailing Address - Fax:
Practice Address - Street 1:6017 E POWDER HOUSE CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-7468
Practice Address - Country:US
Practice Address - Phone:605-929-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist