Individual
MRS. DIANE MARIE KLIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-5534
(920) 361-5190
Mailing address
464 RIVER DR, BERLIN, WI 54923-1133
(920) 229-1179
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4054-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40181000
—
WI
Enumeration date
04/13/2008
Last updated
04/13/2008
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