Individual
MS. THERESA D KLOSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
700 TWINING STREET, MAFB, AL 36112
(334) 953-5143
(334) 953-8296
Mailing address
3181 OLD MILL RUN, MILLBROOK, AL 36054-2810
(334) 290-1826
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1494
AL
Other
Enumeration date
09/12/2005
Last updated
07/08/2007
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