Provider Demographics
NPI:1922706308
Name:KLOC, JENNIFER ROBIN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ROBIN
Last Name:KLOC
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2013
Mailing Address - Country:US
Mailing Address - Phone:716-675-3380
Mailing Address - Fax:716-675-3380
Practice Address - Street 1:1909 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2013
Practice Address - Country:US
Practice Address - Phone:716-675-3380
Practice Address - Fax:716-675-3380
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031728225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist