Provider Demographics
NPI:1932393964
Name:KLEIN, KIMBERLY ANN
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
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 1:105 CHADBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1647
Mailing Address - Country:US
Mailing Address - Phone:330-463-0218
Mailing Address - Fax:
Practice Address - Street 1:14100 CEDAR RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3212
Practice Address - Country:US
Practice Address - Phone:216-691-9602
Practice Address - Fax:216-691-9612
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist