Individual
JENNIFER KLODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6169
SC
225100000X
Physical Therapist
Primary
PT2518
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100441
ANTHEM
ME
01
—
1284241
AETNA
ME
Enumeration date
02/20/2007
Last updated
03/22/2024
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