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Individual
MR. KENNETH WADE KLARE
Active
Individual
MR. KENNETH WADE KLARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1096576
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0632119-01
—
TN
01
—
6400153
UNITED HEALTHCARE
TX
01
—
7019083
AETNA HEALTHCARE
TX
01
—
83755T
BCBS OF TEXAS
TX
Enumeration date
07/20/2005
Last updated
04/05/2012
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