Provider Demographics
NPI:1356568679
Name:KLEIN, VICKIE JO
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:JO
Last Name:KLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8216 W 143RD TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1366
Mailing Address - Country:US
Mailing Address - Phone:913-851-4755
Mailing Address - Fax:
Practice Address - Street 1:3215 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2645
Practice Address - Country:US
Practice Address - Phone:816-931-3215
Practice Address - Fax:816-931-3217
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001459492278P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Rehabilitation