Individual
MRS. JODI L KLEMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
593 COLLIER DR, ANTIOCH, IL 60002-8913
(262) 818-1182
Mailing address
593 COLLIER DR., ANTIOCH, IL 60002-2526
(262) 818-1182
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1052-19
WI
225200000X
Physical Therapy Assistant
Primary
160-003144
IL
Other
Enumeration date
05/12/2010
Last updated
09/19/2012
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