Provider Demographics
NPI:1912698366
Name:KLOSTER, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:KLOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 ROCKFORD RD
Mailing Address - Street 2:
Mailing Address - City:GREAT CACAPON
Mailing Address - State:WV
Mailing Address - Zip Code:25422-3387
Mailing Address - Country:US
Mailing Address - Phone:304-258-5627
Mailing Address - Fax:
Practice Address - Street 1:1182 ROCKFORD RD
Practice Address - Street 2:
Practice Address - City:GREAT CACAPON
Practice Address - State:WV
Practice Address - Zip Code:25422-3387
Practice Address - Country:US
Practice Address - Phone:304-258-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant