Provider Demographics
NPI:1972843878
Name:KLOSS, JOSEPH EDMUND (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:EDMUND
Last Name:KLOSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 TANAGER CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3120
Mailing Address - Country:US
Mailing Address - Phone:864-360-8215
Mailing Address - Fax:
Practice Address - Street 1:620 TANAGER CT
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-3120
Practice Address - Country:US
Practice Address - Phone:864-360-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist