Individual
KRISTIN KLASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-5534
Mailing address
225 MEMORIAL DR, BERLIN, WI 54923-1243
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1510-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1510-19
LICENSE ST OF WISCONSIN
WI
Enumeration date
11/23/2011
Last updated
11/23/2011
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