Provider Demographics
NPI:1649898990
Name:KLEINSCHMIDT, JOHNNIE L (PT, PRPC)
Entity type:Individual
Prefix:
First Name:JOHNNIE
Middle Name:L
Last Name:KLEINSCHMIDT
Suffix:
Gender:F
Credentials:PT, PRPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 IHLES RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5900
Mailing Address - Country:US
Mailing Address - Phone:337-302-9121
Mailing Address - Fax:
Practice Address - Street 1:4845 IHLES RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5900
Practice Address - Country:US
Practice Address - Phone:337-438-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020812251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic