Individual
TRAVIS W KLEINENDORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3310 SW 9TH ST, DES MOINES, IA 50315-7647
(515) 244-5005
(515) 244-2202
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 515-2445
(515) 244-2202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004047
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265623128
—
IA
01
—
70255
WELLMARK BLUE SHIELD
IA
Enumeration date
08/06/2007
Last updated
01/09/2020
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