Provider Demographics
NPI:1457787830
Name:KLUGH, JESSICA RAE (AT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:KLUGH
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 UNIVERSITY ESTATES BLVD
Mailing Address - Street 2:APT. 305
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-8087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 UNIVERSITY ESTATES BLVD
Practice Address - Street 2:APT. 305
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-8087
Practice Address - Country:US
Practice Address - Phone:724-766-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist