Individual
KELLY KLIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2079
Mailing address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1464
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11088-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36187500
—
WI
Enumeration date
10/28/2008
Last updated
10/28/2008
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