Provider Demographics
NPI:1669156600
Name:KLEIN, ALISSA MIN (DPT)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:MIN
Last Name:KLEIN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1509
Mailing Address - Country:US
Mailing Address - Phone:703-969-7873
Mailing Address - Fax:
Practice Address - Street 1:3600 CLIPPER MILL RD STE 115
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1957
Practice Address - Country:US
Practice Address - Phone:443-961-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29477225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist